Southdene Surgery

Updated 15 June 2018

Southdene Surgery provides GP primary medical services to approximately 7,400 patients living in the London Borough of Redbridge. The practice is part of NHS Redbridge Clinical Commissioning Group (CCG) which consists of 48 GP practices.

The Practice is located in an affluent suburban area with a low rate of unemployment and other social issues. Although the list size has increased by 10% since the last CQC inspection in 2016, the age demographics have remained the same meaning a lower than average mumber of under 14 year old patients and a higher than average number of over 65 year olds when compared with CCG averages. The percentage of patients with long term conditions is lower than the national average and is consistent with low deprivation levels. Mental health registers, especially depression, are higher than the national average which is expected from affluent area as patients are more likely to seek help and are more open to mental health issues. There is a longer life expectancy than the national average which places different pressures on the practice. Thirty one percent of the registered practice population were from Black, Asian and Minority Ethnic groups with the remaining 69% being white.

Information published by Public Health England rates the level of deprivation within the practice population group as seventh on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

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 and treatment of disease, disorder or injury.

The practice provides a range of services including maternity care, childhood immunisations, chronic disease management and travel immunisations and also a number of enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract) including minor surgery, coil fitting and learning disability health checks. Private travel vaccinations are offered in addition to those available free of charge on the NHS.

The practice team is made up of three female GP Patners and one male and one female salaried GP providing 23 sessions per week, a practice manager, advanced nurse practitioner, practice nurse, health care assistant, reception manager and 12 administrative staff.

The practice is open between 7:30am-8:00pm on Monday, 8:00am-6:30pm Tuesday to Friday and between 9:00am-4:30pm every second and fourth Saturday.

Appointments are from 7:30am-8:00pm on Monday and 8:40am-6:00pm Tuesday to Friday.

Home visits are provided for patients who are housebound or too ill to visit the practice.

Walk-in clinics are held every day from 9am to 11am and 3pm to 5pm. These are run by the advanced nurse practitioner who is supported by the on call GP. Four morning and afternoon GP appointments are also reserved each day specifically for children under one year old. They either can come in or pre-book these appointments.

One nursing home is also looked after and weekly visits are undertaken. This is rotated between 5 GPs and the rota is incorporated within the normal weekly clinic set up.

The practice has a Personal Medical Services (PMS) contract (PMS is one of the three contracting routes that have been available to enable the commissioning of primary medical services).

The practice has opted out of providing an out-of-hours service. When closed, patients are directed to the local out-of-hours service provider. Information regarding this is given on the practice website and the practice leaflet, together with details of the NHS 111 service.

Appointments can be booked online, some being available the next day. Urgent appointments are also available for patients who need them.

A GP Partner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Updated 15 June 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 14 September 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced inspection at Southdene Surgery on 7 March 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

There was a strong focus on continuous learning and improvement at all levels of the organisation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 November 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 above the national averages. For example, the percentage of patients with diabetes, on the register, who received an influenza immunisation, was 96% in comparison to the national average of 94%; and the percentage of patients with diabetes, on the register, who received a foot examination, was above the national average at 92% in comparison with 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 29 November 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.

• The practice’s uptake for the cervical screening programme was 81%, which was comparable to 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 health visitors.

Updated 29 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 undertook weekly visits to a local nursing home to provide care for patients registered with the practice.

Updated 29 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 offered appointments from 7:00am to 7:50pm on Mondays and appointments on the second and fourth Saturdays of the month for working patients who could not attend during normal opening hours.

• 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 29 November 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 above the national averages. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan was 90% and the national average is 88%.

• The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months was 87% which was above the national average of 84%.

• 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 facilitated the local Improving Access to Psychological Therapies (IAPT) service by providing a consulting room for them one day a week to provide therapy for practice patients and patients from other local practices.

• 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 29 November 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 those with a learning disability.

• The practice offered double 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. The practice used the ‘Redbridge First Response Service’ which is an umbrella referral service to assist patients in vulnerable situations such as homelessness, domestic abuse and financial difficulty.

• 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.