Archived: Dr Elizabeth Densham

Updated 28 March 2018

Dr Elizabeth Densham, St Quintin Health Centre, St Quintin Avenue, London, W10 6NX www.stquintinhealthcentre-gppractice.co.uk provides primary medical services through a General Medical Services (GMS) contract within the London Borough of Kensington and Chelsea. The services are provided from a single location to around 2400 patients. The local population is characterised by a large proportion of young working age residents and is ethnically diverse as a result of high levels of migration in and out the borough. The proportion from Black and Minority ethnic groups is twice that found in the rest of the borough.

Updated 28 March 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Elizabeth Densham on 22 March 2016. The overall rating for the practice was good. However they were rated as requires improvement in safe. The full comprehensive report on the March 2016 inspection can be found by selecting the ‘all reports’ link for Dr Elizabeth Densham on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 16 January 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

• The practice had some systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Continue to identify carers in order for them to receive appropriate care and support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 June 2016

The provider was rated as requires improvement for effective and well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

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

• The practice had scored 97.2% on the recent QOF report for diabetes which was above the CCG average.

• Longer appointments and home visits were available when needed.
• 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 14 June 2016

The provider was rated as requires improvement for effective and well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk. For example, they would refer families for additional support and had multidisciplinary meetings with health visitors where any safeguarding concerns would be discussed.

• 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 offered appointments on the day for all children when their parent requested the child be seen for urgent medical matters.
• We saw positive examples of joint working with midwives and health visitors. Monthly meetings were held, 

Updated 14 June 2016

The provider was rated as requires improvement for effective and well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients over 75 years had a named GP to co-ordinate their care.

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

Updated 14 June 2016

The provider was rated as requires improvement for effective and well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The practice offered working age patients access to extended appointments once a week. They also had GP telephone call backs which enabled telephone consultations where appropriate, without patients having to take time off work.

• They offered on-line services which included appointment management, viewing patient records, repeat prescriptions and registration.

• Patients had access to NHS health checks for people aged 40–74. Appropriate follow-ups for the outcomes of health assessments and checks were made, where abnormalities or risk factors were identified.

Updated 14 June 2016

The provider was rated as requires improvement for effective and well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The practice had a register of patients experiencing poor mental health. These patients were invited to attend annual physical health checks and all 35 had been reviewed in the last 12 months.

• Reception staff we spoke with were aware of signs to recognise for patients in crisis and to have them urgently assessed by a GP if presented.

• The practice had achieved 100% of the latest QOF points for patients with Dementia which was above both CCG and national averages.

• The practice had annual reviews for patients with dementia, which included early consideration of advance care planning and discussing power of attorney issues. All dementia patients had a care plan which both they and carers had been involved in drafting.

Updated 14 June 2016

The provider was rated as requires improvement for effective and well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The GPs told us that patients whose circumstances may make them vulnerable such as people with learning disabilities, were coded on appropriate registers.

• These patients had ‘pop ups’ on their computer notes to alert all members of staff of vulnerable patients. GPs told us this was to allow them to meet their specific additional needs such as double appointments, interpreter, visual/hearing impaired, carer details, and risk assessment stratification.

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• Patients with learning disabilities were invited annually for a specific review with their named GP. We saw of the 20 on the register 10 had reviews carried out in the last 12 months.