Wickham Park Surgery

Updated 29 September 2016

Wickham Park Surgery is situated in a converted house in a residential area of West Wickham, in the London Borough of Bromley. Bromley Clinical Commissioning Group (CCG) are responsible for commissioning health services for the locality.

In 1981 the practice moved to the current premises at 2 Manor Road, West Wickham, Bromley BR4 9PS. The practice list size has almost doubled since moving to the property with the result that the practice has outgrown the premises.

The practice is registered with the CQC as a Partnership. Services are delivered under a Personal Medical Services (PMS) contract. The practice is registered with the CQC to provide the regulated activities of family planning; maternity and midwifery services; treatment of disease, disorder and injury, surgical procedures and diagnostic and screening procedures.

The practice has 5040 registered patients. The practice age distribution is similar to the national average. The surgery is based in an area with a deprivation score of 9 (with 1 being the most deprived and 10 being the least deprived).

GP services are provided by two full time GP partners (male and female); two part-time salaried GPs (0.75 wte) and one part-time locum GP (covering maternity leave ) (0.33 wte).

Clinical services are also provided by two part-time Practice Nurses (0.71 wte) and one part-time Health Care Assistant (0.42 wte).

Administrative services are provided by a Practice Manager (1.0 wte), a Reception Manager/Administrator (1.0 wte), a Secretary/Records Summariser (0.42 wte) and five part-time reception staff (2.79 wte).

The practice provides the following Directed Enhanced Services (DES): Childhood Vaccination and Immunisation Scheme; Extended Hours Access; Facilitating Timely Diagnosis and Support for People with Dementia; Influenza and Pneumococcal Immunisations; Learning Disabilities; Minor Surgery; Rotavirus and Shingles Immunisation and Unplanned Admissions. (Enhanced Services are services which require an enhanced level of provision above what is expected under a core contract).

Wickham Park Surgery is a teaching practice providing placements for medical students from Kings College London GKT School of Medicine.

The reception and telephone lines are open between 8am and 6.30pm Monday to Friday with extended hours for reception from 7.15am to 8am on Friday and from 6.30pm to 8pm on Tuesday.

Pre-booked and urgent appointments are available with the GP from 8.30am to 11.30am and from 4pm to 6pm Monday to Friday. In addition a Monday surgery offers appointments between 1.30pm and 3.30pm. Extended hours are provided between 6.30pm and 8pm on Tuesday and between 7.15am and 8.30am on Friday.

Appointments are available with the Practice Nurse between 9am and 1pm Monday to Friday and between 4pm and 6.30pm Tuesday and Wednesday. Extended hours are provided between 6.30pm and 8pm on Tuesday and between 7.15am and 8.30am on Friday.

Appointments are available with the Health Care Assistant between midday and 5pm on Wednesday and between midday and 6pm on Thursday and Friday.

When the surgery is closed, urgent GP services are available via NHS 111.

An informative practice leaflet and practice website provide details of services provided by the surgery and within the local area.

Updated 29 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wickham Park Surgery on 14 June 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. However, not all staff were aware of the location of the practice emergency equipment and medicines.
• 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 adequate facilities and was equipped to treat patients and meet their needs. However, the premises had restricted capacity and was in need of updating and redecoration. The provider was awaiting the outcome of negotiations with NHS England regarding the possibility of relocation to purpose-built premises in 2018.
• 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.

There were areas where the provider should make improvements.

• The provider should keep a record of batch numbers of blank prescriptions placed in printers.
• The provider should ensure all staff are aware of the location of emergency medicines and equipment.
• The provider should consider completing an action plan to identify priority issues to be addressed in relation to the practice facilities if negotiations for relocation are unsuccessful and to cover the interim period, before the move takes place, if negotiations are successful.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 29 September 2016

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

• GPs worked closely with practice nursing staff and community specialist nurses in the management of patients with long-term conditions.

• Patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related Quality Outcomes Framework (QOF) indicators was 94% which was above the local average of 87% and national average of 89%.

• Longer appointments and home visits were available when needed.

• 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. These patients were discussed at the quarterly multi-disciplinary team meetings.

• The practice had developed protocols which flag patients who might be at risk of developing long-term conditions related to historical disease or treatment.

Updated 29 September 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 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. A ‘Congratulations’ letter was sent to postnatal mothers which encouraged them to attend for screening and immunisations.

• The practice offered post-natal and routine temporary resident care to patients in the Mother and Baby Unit of the local mental health trust.

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

• The percentage of women aged 25-64 years who had received a cervical screening test in the preceding 5 years was 87% which was comparable to the CCG average of 84% and 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 who held an antenatal clinic at the surgery every fortnight and Health visitors, from both local CCGs, who attended quarterly safeguarding meetings at the surgery.

Updated 29 September 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.

• Performance for Quality Outcomes Framework (QOF) indicators for conditions found in older people were above the Clinical Commissioning Group (CCG) and national average.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Annual Flu Clinics were held in a local church hall for ease of access to patients and refreshments were provided to encourage patients to spend time talking and socialising.

Updated 29 September 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. Patients were notified of the receipt of pathology test results by text and the practice provided systems for the requesting of repeat prescriptions through the on-line system and by email.

• A full range of health promotion and screening services were provided that reflects the needs for this age group.

Updated 29 September 2016

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

• 90% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the preceding 12 months, which was above the CCG and national average of 84%.

• 96% of patients diagnosed with a mental health disorder had a comprehensive agreed care plan documented in the preceding 12 months, which was above the CCG average of 84% and national average of 88%.

• 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.

• A counsellor held twice weekly clinics in the surgery.

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

• The practice provided patients with CDs for relaxation exercises and coping with anxiety advice.

• 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 and would alert the partners if they had concerns regarding a patient’s memory.

Updated 29 September 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.

• In the winter months the practice partners volunteer at the local homeless shelter.

• The practice provided care for a large refugee population housed in the practice catchment area and maintained strong links with the local interpreting services and refugee support charities and were aware of referral routes to specialist services for victims of torture.

• The practice offered longer appointments and annual reviews for patients with a learning disability. 100% of patients had attended for their annual review.

• 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.