Pentelow Practice

Updated 21 September 2016

The Pentelow Practice, is a part of Hounslow CCG.. The building is situated on a main road. The practice is located on the ground and first floor of a purpose built property. There are three consulting rooms, all on the ground floor. There are two toilets one for patients with disabled access and one for staff. Access to the surgery is via the main front entrance of the building on level flooring and side entrance with automatic doors for wheelchair access. The practice also has a car park for patients and staff.

The practice operates under a General Medical Services (GMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract).

The service is registered with the Care Quality Commission to provide regulated activities of; diagnostics and screening services and treatment of disease, disorder or injury.

The practice is run two GP partners (both male). The partners are supported by one salaried GP, one female locum GP, one healthcare assistant (HCA), one practice manager and reception staff.

The GP’s collectively provided 16 clinical sessions a week.

The practice is open between 9:00am to 6:30pm Monday to Friday. Appointments are available from 9:00am to 6:30pm. The practice is open between 8:30am to 1:00pm and 2:00pm to 6:30pm. The practice is not contracted to provide extended surgery hours. When the practice is closed patients can call NHS 111 in an emergency or a local out of hour’s service.

The practice has a patient list size of approximately 3,026 patients. The practice is situated in an area which is classified as the fifth more deprived decile. The majority of the patients within the practice are either young or of working age. A small percentage of patients are aged between 75 and 85.

Updated 21 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Pentelow Practice on 18 May 2016, overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• 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.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, except that on two recent occasions the analysis which took place following significant events was not documented.
• 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.
• Risks to patients were assessed and well managed, except that the practice had not retained a copy of the most recent Portable Appliance Testing certificate.
• 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 provider should make improvements are:

• Review arrangements in place to ensure that patients with caring responsibilities are identified, so their needs are identified and can be met.

• Review the process for documenting discussions, decisions and actions for audit purposes.

• Review the process for adequately mitigating the risk of not having a defibrillator.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 September 2016

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.

• 80% of patients diagnosed with asthma had an asthma review in the last 12 months; this was comparable to the local average of 75% and national average of 75%.

• Performance for diabetes related indicators was comparable to the local and national average, for instance:

• 66% of patients with diabetes on the register had their blood sugar recorded as well controlled (local average 68%, national average 77%).
• 81% of patients with diabetes on the register had their cholesterol measured as well controlled (local average 74%, national average 81%).
• 90% of patients with diabetes on the register had a recorded foot examination and risk classification (local average 85%, national average 88%).

• 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 21 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 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.
• 80% of women aged 25-64 had it recorded on their notes that a cervical screening test has been performed in the preceding five years; this was comparable to the local CCG average of 78% 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 and health visitors.

Updated 21 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.

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

• 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 21 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 as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 21 September 2016

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

• Performance for mental health related indicators was comparable to the local and national average:

• 90% of patients diagnosed with dementia had a recorded review in a face to face meeting in the last 12 months (local average 83%, national average 84%).

• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months (local average 91%, national average 90%).

• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the last 12 months (local average 87%, national average 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.

• 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 21 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.

• 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.