Island Health - Care Quality Commission

Background to this inspection

Updated 2 June 2017

Island Health is located on the Isle of Dogs in east London. It is one of the 36 member GP practices in NHS Tower Hamlets CCG which are organised into eight commissioning networks. Island Health is one four practices forming the Healthy Island Partnership commissioning network. The aim of the network is to work together with patients and other local colleagues, for example pharmacists, children’s centres, voluntary sector organisations, schools and the local authority, to improve health and wellbeing.

Tower Hamlets is ethnically diverse with around half the population comprising of Black and Minority Ethnic groups. The largest of these is the Bangladeshi community (33%). The practice is located in the fifth more deprived decile of areas in England. At 79 years, male life expectancy is equal to the England average of 79 years. At 84 years, female life expectancy is greater than the England average of 83 years.

The practice has approximately 11,750 registered patients. It has fewer patients aged 45 years and above compared with the England average, and a larger number of patients in the 25 to 39 years age range than the England average. Services are provided by the Island Health partnership under a General Medical Services (GMS) contract with NHS England.

The practice is in purpose built health care premises owned by a local charitable trust. It is close to public transport and has a car park. All patient areas are accessible to wheelchair users and there is a disabled toilet. The practice has ten consulting rooms, four treatment rooms and a blood tests room. The practice shares the building with a dental surgery and with district nursing and health visiting services.

There are six partners and six salaried GPs who provide the equivalent of 6.75 whole time GPs. There are eight female and four male GPs. There are three part time nurse practitioners (1.72 whole time equivalent), one full time practice nurse, one full time practice nurse-in-training, and a part time health care assistant (0.83 WTE). There is a team of reception, administrative, secretarial and book keeping staff led by a reception manager and practice manager. One of the receptionists is also a trained phlebotomist.

The practice is an accredited GP training and teaching practice and three of the GPs are approved trainers. There were two GP in training doctors attached to the practice at the time of our visit. Some of the GP partners had completed their GP training at the practice.

The practice is open 8.00am to 6.30pm, Monday to Friday. Outside these times patients are directed to an out of hours GP services. In addition, the practice is open for booked appointments until 8.00pm on Monday and Wednesday, and from 7.00am on Thursday. Appointments are also available at another local practice between 8.00am and 8.00pm on Saturday and Sunday under GP hub arrangements in Tower Hamlets.

Island Health is registered with the Care Quality Commission to carry on the following regulated activities at 145 East Ferry Road, Isle of Dogs, London E14 3BQ: Diagnostic and screening procedures; Family planning, Maternity and midwifery services, Surgical procedures and Treatment of disease, disorder or injury.

Overall inspection

Good

Updated 2 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Island Health on 19 May 2016. The overall rating for the practice was good. The full comprehensive report published on 27 July 2016 can be found by selecting the ‘all reports’ link for Island Health on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 18 April 2017 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 on 19 May 2016. There were concerns relating to the management and storeage of medicines, staff training, medical indeminity insurance and the assesments of staff who may require Disclosure and Barring Service (DBS) checks and to what level. 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.

Our key findings 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.
Safety systems and processes were embedded, with the exception of those relating to medicines storage and recruitment.
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.

At our previous inspection on 19 May 2016, we rated the practice as requires improvement for providing safe services as not all medicines were accounted for, there was a member of staff employed who did not have valid medical indemnity insurance and not all staff had Disclosure and Barring Service (DBS) checks consummate to their roles. At this inspection we found that all medicines were stored appropriately and accounted for, all clinical staff had the appropriate medical indemnity insurance and the practice had developed a DBS protocol which risk assessed staff according to their role which then determined the level of DBS or if it was required.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice