Dr Dassanayake & Partners Also known as The New Surgery

Updated 24 May 2016

The New Surgery provides GP primary care services to approximately 5500 people living in the Shepherds Bush area of Hammersmith and Fulham. Shepherds Bush is a mixed community and the practice is located in an area which is amongst the most densely populated ward in the borough. Almost 30% of children live in poverty, nearly 45% of the population were born abroad and only 15% of residents speaks English as main language.

The practice is staffed by three GPs, two males and one female doctor who work a combination of full and part time hours, totalling 2.5 WTE. Other staff included a nurse, a Health Care Assistant (HCA) and four 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 7.00am to 6.30pm Mondays to Friday, except Thursday when they closed at 1pm. They had extended hours on Monday to Friday between 7.00am and 8.30am. The telephones were staffed throughout working hours. 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 two 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.

Updated 24 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Jolly and Partners on 23 February 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 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.
• Patients said that 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:

• Ensure that conversations taking place in the treatment rooms cannot be overheard from the waiting area.
• Ensure patients with caring responsibilities are proactively identified.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 May 2016

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

• The practice was pro-actively managing patients with Long term conditions (LTC). One GP was the lead on managing patients with diabetes. The practice nurse was involved with performing diabetes health checks and monitoring for practice patients and patients in the locality if required through the Out of Hospital services.

• 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.
• The practice had scored 80% on the recent QOF report for diabetes which was below the CCG average.
• Longer appointments and home visits were available when needed.

Updated 24 May 2016

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

• Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk. For example, they would refer families for additional support and had multidisciplinary meetings with health visitors where any safeguarding concerns would be discussed.

• The practice triaged all requests for appointments on the day for all children when their parent requested the child be seen for urgent medical matters, thus were able to offer appointments at a mutually convenient times, for example after school, when appropriate
• We saw positive examples of joint working with midwives and health visitors and monthly meetings were held.
• The GPs demonstrated an understanding of Gillick competency and told us they promoted sexual health screening.

Updated 24 May 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. Patients over 75 years had a named GP to co-ordinate their care.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs

Updated 24 May 2016

The practice is rated as good for the care of working age people (including those recently retired and students).

• The practice offered working age patients access to extended appointments every weekday morning .

• They offered on-line services which included appointment management, viewing patient records, repeat prescriptions and registration. They also had GP telephone triage for all requests for same day appointments, which enabled telephone consultations where appropriate, without patients having to take time off work .

• Patients had access to NHS health checks for people aged 40–74. Appropriate follow-ups for the outcomes of health assessments and checks were made, where abnormalities or risk factors were identified .

Updated 24 May 2016

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

• The practice had a register of patients experiencing poor mental health. These patients were invited to attend annual physical health checks and 43 out of 53 had been reviewed in the last 12 months.

• There was a primary care mental health worker (PCMH) based at the practice one day every two weeks, whose role included supporting patients with mental illness transfer from secondary care back to primary care. GPs could also refer new patients to them.

• There were regular reviews of all patients being seen by the PCMH worker with the lead GP

• Reception staff we spoke with were aware of signs to recognise for patients in crisis and to have them urgently assessed by a GP if presented.

• The practice had achieved 100% of the latest QOF points for patients with Dementia which was above both CCG and national averages.

• The practice had annual reviews for patients with dementia, which included early consideration of advance care planning . All dementia patients had a care plan which both they and carers had been involved in drafting.

• Dementia friendly training had been arranged for all staff at the practice.

• We were told that they had made improvements to the practice to make it more 'dementia friendly', such as re-arranging the chairs in the waiting area and changing the colours of the furnitiure and toilet seats.

Updated 24 May 2016

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

• The GPs told us that patients whose circumstances may make them vulnerable such as people with learning disabilities and homeless patients, were coded on appropriate registers.

• These patients had ‘pop ups’ on their computer notes to alert all members of staff of vulnerable patients. GPs told us this was to allow them to meet their specific additional needs such as double appointments, interpreter, visual/hearing impaired, carer details, and risk assessment stratification.
• Patients with learning disabilities were invited annually for a specific review with their named GP. We saw 14 out of 15 on the register had reviews carried out in the last 12 months.

• The practice had eleven homeless patients and had signed up to the local Out of Hospital care of homeless patients. They gave out food vouchers to this group. They offered double appointment to manage complex needs.

• The patient list included women living in a refuge. These women were offered double appointments as standard as the GPs told us they often had complex medical and psychological needs. They said they encouraged these women to call the surgery for an emergency appointment if there was a crisis event.