Thornton Road Surgery

Updated 18 November 2016

Thornton Road Surgery is a medium sized practice based in Croydon. The practice list size is 7722. The practice population is very diverse. The practice is in an area in London of medium deprivation. There is a higher than average percentage of working age patients (aged 25-40) and also a higher than average number of unemployed patients. The practice had a Primary Medical Services (PMS) contract.

The practice facilities include seven consulting rooms, two treatment rooms, one patient waiting room and administration offices. The premises are wheelchair accessible and there are facilities for wheelchair users including a disabled toilet and hearing loop.

The staff team compromises five salaried GPs (three male and two female) and one locum GP providing a total of 31 GP sessions per week. There are two female practice nurses, a female associate practitioner, a practice manager and an assistant practice manager. Other practice staff include a reception manager, five receptionists (four female and one male) and three administrators.

The practice is open between 8am and 6.30pm on Monday, Wednesday and Friday; between 8am and 8pm on Tuesday and Thursday and on Saturday between 9am and 1pm. Appointments are available between 9am and 12noon and between 3pm and 6pm Monday to Friday, with extended hours on Tuesday and Thursday until 8pm. In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments, home visits and telephone consultations were also available for people that needed them.

When the practice is closed patients are directed (through a recorded message on the practice answer phone) to call the local out of hours provider, or go to the nearby minor injuries units which are open from 2pm to 8pm every day, and the nearby walk-in centre which is open from 8am to 8pm every day. This information is also available on their website.

The practice is registered as an organisation with the Care Quality Commission (CQC) to provide the regulated activities of; treatment of disease, disorder and injury; diagnostic and screening procedures and maternity and midwifery services.

Updated 18 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at on 27 July 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had taken several steps to improve their care for people with long term conditions such as medicines synchronization, increased support for patients with diabetes and a robust system of recalling these patients for health checks and medicine reviews.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a strong culture of learning and development, with a structured coaching programme in place.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 18 November 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Patients with long term conditions and complex health needs were invited to the practice by the practice pharmacist, to review their medicines and synchronize their prescriptions. This reduced the number of times these patients would need to contact the practice for repeat prescriptions, and helped the practice identify patients who were not adhering to prescriptions.

• The practice had begun a recall centralization pilot which used practice data to identify batches of patients who had particular conditions such as diabetes or hypertension. These batches of patients were recalled to the practice for a full range of health and medicine reviews as appropriate.

• The practice was above local and national averages for its clinical performance for patients with diabetes.

• The practice had assigned additional clinical staff to their diabetes clinic due to a high local prevalence of this condition.

• Longer appointments and home visits were available when needed and information about this was on display in the reception area.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 18 November 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• The practice used a protocol for children who did not attend for appointments, which was designed to ensure families are contacted by text message in these instances, and the healthcare assistant would follow up to make contact. If a child repeatedly missed appointments they would be discussed at clinical meetings.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 85%, which was comparable to the CCG average of 82% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 18 November 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• All requests for home visits were passed to a doctor for assessment and a follow up telephone call.

Updated 18 November 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice was among the highest performing in its local area for uptake of online services.

Updated 18 November 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The number of patients diagnosed with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months was 100% compared to the CCG average of 85% and the national average of 84%.

• Performance for mental health related indicators were above CCG and national averages.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 18 November 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• The practice offered longer appointments of up to 40 minutes for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• The practice had identified a number of Sri Lankan patients who had been victims of torture during the Sri Lankan civil war. These patients were either directly referred to, or put in contact with a charitable organisation that helped victims of torture.