8 July 2016
The Sterndale Surgery provides GP primary care services to approximately 4900 people living in the Brook Green area of Hammersmith and Fulham. The local area is a mixed community and there is a wide variation in the practice population, from relatively deprived to extremely affluent and mainly young to middle age.
The practice is staffed by five GPs, two males and three female doctors who work a combination of full and part time hours, totalling 28 sessions. Other staff included a nurse, a Health Care Assistant (HCA), a practice manager and three administrative staff. The practice holds a General Medical Services (GMS) contract and was commissioned by NHSE London. The practice is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, treatment of disease, disorder and injury and maternity and midwifery services.
The practice was open from 8.30am to 6.30pm Mondays to Friday, except Wednesdays when they closed at 1pm. They had extended hours on Mondays and Thursdays from 7am to 8am. Patients had access to GPs at other local surgerys on Saturday and Sundays 9am to 4pm. The telephones were staffed throughout working hours, except between 1.00pm and 2.00pm. Appointment slots were available throughout the opening hours. The out of hours services are provided by an alternative provider. The details of the ‘out of hours’ service were communicated in a recorded message accessed by calling the practice when closed and details can also be found on the practice website. Longer appointments were available for patients who needed them and those with long-term conditions. This also included appointments with a named GP or nurse. Pre-bookable appointments could be booked up to three weeks in advance; urgent appointments were available for people that needed them.
The practice provided a wide range of services for patients with diabetes, chronic obstructive pulmonary disease (COPD), contraception and child health care. The practice also provided health promotion services including a flu vaccination programme and cervical screening.
8 July 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Sterndale Surgery on 27 April 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 provider should make improvement are:
- The practice should ensure that all electrical equipment is checked annually to ensure the equipment is safe to use.
- The practice should ensure that conversations taking place in all treatment rooms cannot be overheard by patients in the waiting room.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
8 July 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.
- Performance for diabetes related indicators was 91%, which was 8% above the CCG and 2% above national averages.
- 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.
8 July 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.
- The practice’s uptake for the cervical screening programme was 78%, which was above the CCG average and below the 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
8 July 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. One GP specifically focused on older people care and carried out home visits when needed.
- Patients over 75 years had a named GP to co-ordinate their care.
- The practice had access to and made use of local initiatives such as OPRAC (older person rapid access clinic) and virtual wards which helped improve the care of the elderly in the community.
8 July 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.
8 July 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- 100% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average.
- Patients experiencing poor mental health were invited to attend annual physical health checks and 52 out of 58 had been reviewed in the last 12 months.
- The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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.
8 July 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.