Wanstead Place Surgery

Updated 16 March 2017

Wanstead Place Surgery is located in a residential area of Wanstead, North East London The practice is located in a two storey converted building. There is parking (permit-only) on the streets nearest to the practice, and a parking bay for disabled patients at the front of the surgery. The nearest bus stop is approximately five minutes’ walk from the practice.

The practice operates from:

45 Wanstead Place

Wanstead

London

E11 2SW

There are approximately 8500 patients registered at the practice. Statistics shows moderate to low income deprivation among the registered population. The registered population is slightly higher than the national average for those aged between 0-4 and between 25-44. Patients registered at the practice come from a variety of backgrounds including Asian, Western European, Eastern European and Afro Caribbean.

Care and treatment is delivered by four GPs (two male and two female) which includes three partners and one salaried GP who provide thirty clinical sessions per week. There is one practice nurse (female) who works eight sessions per week. Five administrative staff work at the practice and are led by a practice manager. The practice was a teaching and training practice. The practice was hosting three GP trainees on the day of inspection.

The practice is open from the following times:-

• 8am – 8pm (Monday)

• 8am – 7pm (Tuesday, Wednesday,Thursday)

• 8am – 6:30pm (Friday)

Clinical sessions are run during the following times:-

• 8:30am - 1:15pm; 2:30pm - 8pm (Monday)

• 8:30am - 12:50pm; 1:30pm -7pm (Tuesday)

• 8:30am – 12:50pm; 1:30pm - 3:30pm; 4pm - 7pm (Wednesday)

• 8:30am - 1:15pm; 2:50pm - 7pm (Thursday)

• 8:30am - 1:15pm; 1:30pm - 6:30pm (Friday)

Extended hours surgeries are offered on a Monday, Tuesday, Wednesday and Thursday evenings Patients can book appointments in person, by telephone and online via the practice website.

Patients requiring a GP outside of practice opening hours are advised to contact the NHS GP out of hours service on telephone number 111.

The practice has a Personal Medical Services (PMS) contract. PMS contracts are nationally agreed between the General Medical Council and NHS England. The practice conducts the following regulated activities:-

- Diagnostic and screening procedures

- Treatment of disease, disorder or injury

- Maternity and midwifery services

- Surgical procedures

- Family planning

Redbridge Clinical Commissioning Group (CCG) is the practice’s commissioning body.

Wanstead Place Surgery has not previously been inspected by the CQC.

Updated 16 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wanstead Place Surgery on 05 October 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.
• The practice hosted in-house gynaecology and dermatology clinics.
• The practice engaged with other practices within the locality to foster good working relations and encourage learning through shared good practice and arranging learning events.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice offered minor surgery.
• 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 offered extended hours surgery four times a week.
• The practice offered an in-house acupuncture service.
• 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 practice was aware of and complied with the requirements of the duty of candour.
• The Patient Participation Group (PPG) at the practice was active. Members we spoke to on the day of inspection told us the staff at the practice engaged regularly with the PPG to ensure that patients were aware what was happening within the practice and to seek the PPG and patients views on future plans for the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 March 2017

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.
• The Quality Outcomes Framework (QOF) recorded the practice as scoring higher than the national average on all five of the diabetes indicators.
• 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 16 March 2017

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.
• 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.
• 82% of women aged 25-64 notes record that a cervical screening test has been performed in the preceding 5 years which was above the CCG average of 79% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered chlamydia screening for 15-25 year old patients.

Updated 16 March 2017

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.
• Longer appointments for this population group were available when needed.
• Patients aged 75 and over had a named GP.
• Patients that had been identified as high risk patients because of their needs, received 20 minute appointments.

Updated 16 March 2017

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.
• Telephone consultations with clinicians were available to meet the needs of this population group.
• The practice offered extended hours surgery four times a week to meet the needs of this population group.

Updated 16 March 2017

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

• 91% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the CCG average of 80% and the national average of 84%.
• 91% of patients with schizophrenia, bipolar effective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months, which is comparable to 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 with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice conducted regular medicine review of patients within this group to monitor the effectiveness of their treatment and monitor their physical health.
• 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 16 March 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 homeless people and those with a learning disability.
• 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 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.