Grove Park Surgery

Updated 14 November 2016

Grove Park Surgery provides NHS primary medical services to around 7500 patients in Chiswick, West London through a 'general medical services' contract. The practice is located within Hounslow Clinical Commissioning Group. The service is run from one surgery.

The current practice clinical team comprises three GP partners, two salaried GPs, two practice nurses, a health care assistant and phlebotomists. The practice also employs managers, administrative and reception staff. The GPs provide around 32 sessions a week in total. Patients had a choice of a male or female GP. The practice is a teaching and training practice taking undergraduate medical students on placement and supporting GP trainees for fixed term posts.

The practice is open from 8.15am until 1pm and 2pm until 6.30pm from Monday to Friday and from 8.30am to 10.30am on Saturday. The Saturday morning clinic includes appointments with a nurse, healthcare assistant or GP and is reserved for pre-booked appointments only. The practice operates with a telephone triage system Monday to Friday, that is, a GP assesses patients by telephone and can provide telephone advice or book the patient into a face-to-face consultation. Same day appointments are available for patients with complex or more urgent needs. Pre-bookable non-urgent appointments are available up to eight weeks in advance.

The practice offers online appointment booking and an electronic prescription service. The GPs make home visits to see patients who are housebound or are too ill to visit the practice and carry out a regular weekly visit to patients living in a nearby care home.

When the practice is closed, patients are advised to use a contracted out-of-hours primary care service if they need urgent primary medical care. The practice provides information about its opening times and how to access urgent and out-of-hours services in the practice leaflet, on the NHS Choices website and on a recorded telephone message. Patients also have access to local 'Hub' primary care services in the evening and at weekends and the practice provides weekend Hub services for patients in Hounslow on a monthly rota basis.

The practice population age profile is broadly similar to the English national average. The population in the local area is characterised by below average levels of income deprivation, unemployment and limiting disability and above average life expectancy.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; family planning; maternity and midwifery services; surgical procedures; and treatment of disease, disorder and injury.

CQC has not previously inspected this practice.

Updated 14 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grove Park Surgery on 30 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.
• 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 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 and complied with the requirements of the duty of candour.

The areas where the practice should make improvement are:

• Carry out periodic audits of infection control to ensure it monitors its adherence to current guidelines and identifies any areas for improvement.
• Take steps to proactively identify carers to ensure their needs are being assessed and they are receiving appropriate support.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 14 November 2016

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

• Longer appointments and home visits were available when needed. The practice was able to provide continuity of care to patients with long-term conditions.
• Patients with long-term conditions were offered an annual review to check their health and medicines needs were being met. The practice discussed prevention, effective self-management and when to seek treatment without delay with patients.
• Nursing staff were trained to carry out diabetes, asthma and chronic obstructive pulmonary disease (COPD) reviews.
• Patients at risk of hospital admission were identified as a priority. 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 November 2016

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

• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice prioritised young children and babies for urgent or same-day appointments and offered daily telephone advice slots which were useful for parents.
• The practice ran a weekly drop-in baby clinic which covered infant immunisations, postnatal checks and routine developmental checks. The practice followed up children who did not attend for immunisation.
• 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 high for all standard childhood immunisations.
• The practice provided comprehensive contraceptive services and was sensitive to the needs of teenagers.

• In 2014/15, 80% of practice patients with asthma had an asthma review in the preceding 12 months. This rate was comparable with other practices.

Updated 14 November 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had assigned a GP to the care of patients living at a nearby care home. This GP carried out a regular weekly visit to the home. They also contacted the home every Saturday and provided telephone advice or visited the same day if there were any concerns.

• The practice provided the seasonal flu vaccination for patients over 65 and the shingles and pneumococcal vaccinations for eligible older patients.

Updated 14 November 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 and was open until 6:30pm every weekday and on Saturday morning. 
• The practice operated a daily GP triage system including the facility for telephone advice which was particularly useful for working patients.
• The practice provided comprehensive sexual health and contraceptive services including coil fittings and contraceptive implants.
• The practice offered a full range of health promotion and screening services appropriate for this group. For example in 2014/15, 81% of eligible female patients had a cervical smear in the previous five years which was in line with the national average of 82%.

Updated 14 November 2016

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

• The practice recognised that patients with mental health needs might need urgent and short notice appointments and facilitated this through the telephone triage system. The practice offered longer appointments to patients with mental health problems. Patients could book appointments with a GP or one of the practice nurses who had a special interest in mental health.
• 84% of patients diagnosed with dementia had their care reviewed in a face to face meeting within the last 12 months, which is the same as the national average.
• The practice carried out advance care planning for patients with dementia involving patients' families when appropriate.
• 89% of patients diagnosed with psychosis had a comprehensive, agreed care plan documented in the record, within the last 12 months, which is in line with the 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 provided an in-house counselling service for patients experiencing mental distress. The practice also hosted a weekly psychiatric nurse clinic for patients who required additional support, for example following discharge from acute care.
• The practice informed 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.

Updated 14 November 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held registers of patients living in vulnerable circumstances and ensured they had priority access to appointments when needed.
• The practice offered longer appointments for patients with a learning disability and other complex needs.
• 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. The practice had participated in multi-agency risk assessment conferences when appropriate.