Archived: Dewey Practice

Updated 1 December 2017

Dr Christopher Ola operates from The Surgery, 36 Dewey Road, Dagenham, Essex RM10 8AR. The premises are a converted two-storey, semi-detached house. The consulting rooms are located on the ground floor, with necessary access and facilities for patients with mobility problems.

The practice provides NHS primary medical services through a General Medical Services (GMS) contract to approximately 3,500 patients. The practice is part of the NHS Barking and Dagenham Clinical Commissioning Group (CCG).

The patient profile for the practice indicates a population of more working age people than the national average and a lower proportion of older people in the area compared with the national average.

The provider is a male sole-practitioner working nine sessions per week. At the time of the inspection there were three part-time nurses. There is a practice manager and four administrative staff. Locum clinicians are used to cover absences.

The practice’s morning opening hours are between 9am and 2pm on Monday and 9am to 1pm on Tuesday, Wednesday, Thursday and Friday. Afternoon hours are 3pm to 6.30pm on Monday and 2pm to 6.30pm on Tuesday, Thursday and Friday with the practice staying open until 7.30pm on Wednesday. Telephones are answered from 8.00am to 6.30pm on Monday to Friday.

Consultations are available between 9am and 12 noon Monday to Friday, between 3pm and 6pm on Monday, Tuesday, Thursday and Friday and between 3pm and 7.30pm on Wednesday.

The practice has opted out of providing out-of-hours (OOH) services and referred patients to the local OOH provider when closed. There was also information provided to patients about the NHS 111 service and a nearby walk in centre, a service available to all patients which opened seven days a week.

The practice is registered with the CQC to provide the regulated activities Diagnostic and screening procedures, Family planning, Maternity and midwifery services.

Updated 1 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Christopher Ola on 5 October 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 good facilities and was well equipped to treat patients and meet their needs.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 December 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was comparable to the CCG and national averages. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) is 5 mmol/l or less was 84% compared with the CCG average of 77% and the national average of 80%. The practice exception reporting rate, was 11% compared to the CCG average of 11% and the national average of 13%.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 1 December 2017

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

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.
• Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children, who were always seen on the day, and young people and for acute pregnancy complications.

Updated 1 December 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services including the community tteam and the out of hours provider.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.
• Home visits were often carried out by the Provider during the evenings and at weekends.

Updated 1 December 2017

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

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours and Saturday appointments.
• 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. A website had recently been set up.

Updated 1 December 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 75% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to both the CCG and national averages.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia. It had a register coontaning details of patients with learning disabilities, all of whom had received a health check in the last 12 months.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, compared with the CCG average of 90% and the national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 1 December 2017

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 with a those with a learning disability and, from time to time, homeless people.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.