• Doctor
  • GP practice

Hurley Clinic

Overall: Good read more about inspection ratings

Ebenezer House, Kennington Lane, London, SE11 4HJ (020) 7735 7918

Provided and run by:
Hurley Clinic Partnership

Latest inspection summary

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Overall inspection

Good

Updated 25 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the practice on 19 November 2014. Breaches of legal requirements were found. After the comprehensive inspection, the practice did not submit their action plan. However we were sent the action plan in June 2016 ahead of the focussed inspection. The practice wrote to us to say what they would do to meet the legal requirements in relation to the breaches of regulation 10 (1)(2)(b)(i) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this desk-based focussed inspection on 16 June 2016 to check that they had followed their plan and to confirm that they now met the legal requirements. This report covers our findings in relation to those requirements and also where additional improvements have been made following the initial inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for the Hurley Clinic on our website at www.cqc.org.uk.

Overall the practice was rated as Good. Specifically, following the focussed inspection we found the practice to be good for providing responsive services.

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

  • The practice had implemented some changes to the appointment system to improve access to appointments for patients.
  • Data from the national GP patient survey indicated on-going difficulties with getting through to the practice by telephone and difficulty booking appointments.
  • The practice had improved the communication system in the waiting area for patients.
  • The practice had gathered feedback from patients via their annual survey and complaints which indicated that there was some improvement in satisfaction with appointments.
  • The practice had systems in place to improve the quality of the services provided by gathering the views of service users. There had been evidence of engagement with the Patient Participation Group (PPG) and a patient satisfaction survey had been undertaken.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

People with long term conditions

Good

Updated 23 July 2015

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

Registers were maintained of patients with different long term conditions and they received specific interventions in line with the Quality and Outcomes Framework (QOF), such as periodic reviews and assessments and referrals to other services that may be of benefit to their health and wellbeing. Some allied health professionals were based on the practice site, and their input was sought into the management of these cases.

At the time of our inspection in November 2014, there were 283 patients on the avoiding unplanned admissions for vulnerable people scheme. Most of these patients were older people. These patients had plans of care in place for them and these plans were subject to three monthly reviews. The practice had also started chronic disease management clinics for at risk groups. Patients were provided 30 minute appointments at these clinics which provided time for care planning and any required reviews and assessments.

Families, children and young people

Good

Updated 23 July 2015

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

Appointments were available outside of school hours. Extended hours appointments were available, if they were pre-booked, between 7.00am-8.00am and 6.30pm-7.30pm on Tuesdays and Thursdays.

The premises were suitable for children and babies.

The practice offered a number of online services, including booking and cancelling appointments, requesting repeat medicines, sending secure messages to the practice, viewing medical record and updating patient details.

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 hospital emergency department attendances.

The practice’s performance for childhood immunisations for 2013/14 was relatively high compared to other practices in the local area for all immunisations recommended at 12 months, 24 months and five years of age.

Older people

Good

Updated 23 July 2015

The practice is rated as good for the care of older people.

Quality and outcomes framework (QOF) data showed that the practice performed well against indicators relating to the care of older people. For example, the practice maintained a register of patients in need of palliative care (there were 18 patients on the register), and had regular multidisciplinary integrated care meetings where all patients on the palliative care register were discussed. All the practice patients with rheumatoid arthritis had received an annual face to face review in the 12 months ending 31 March 2014. All their patients with rheumatoid arthritis aged 50 or over and who have not attained the age of 91 had had a fracture risk assessment in the preceding 24 months before 31 March 2014.

The practice maintained a register of older patients, and at the time of our inspection there were 529 patients on this register. All but one of the patients had a named GP.

The practice provided home visits to patients who were housebound. Annual health checks were offered to house bound patients, and at the time of our inspection 75% of these patients has received their annual health check.

Double appointments were available for patients who had that need.

Working age people (including those recently retired and students)

Good

Updated 23 July 2015

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

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.

Appointments were available outside of normal working hours. Extended hours appointments were available, if they were pre-booked, between 7.00am-8.00am and 6.30pm-7.30pm on Tuesdays and Thursdays.

The practice offered a number of online services, including booking and cancelling appointments, requesting repeat medicines, sending secure messages to the practice, viewing medical record and updating patient details.

The practice nurse had oversight for the management of a number of clinical areas, including immunisations, cervical cytology and some long term conditions. The healthcare assistant in the practice led the smoking cessation clinic.

People experiencing poor mental health (including people with dementia)

Good

Updated 23 July 2015

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

The practice provided more specialised care to meet the needs of patients with dementia. These patients were discussed at the practice clinical team meetings, and plans of care were put in place for them.

At the time of our inspection, there were 39 patients requiring additional care for dementia. Records showed that 66% of these patients had had care plans prepared for them.

The practice maintained a register of patients with mental health needs, and there were 193 patients on this register at the time of our inspection. As part of the care provision to this group of patients, care plans were prepared with them. Records showed that 106 patients (55%) had a care plan in place for them.

People whose circumstances may make them vulnerable

Good

Updated 23 July 2015

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 people of no fixed abode and those with a learning disability.

The practice was signed up for the learning disability direct enhanced service (DES). The service involved the practice identifying patients aged 14 and over with the most complex needs and offering them an annual health check as well as a health action plan.

As part of the learning disability DES, the practice maintained a register of patients with learning disabilities. At the time of our inspection in November 2014, five of the 76 patients on the learning disabilities register for the 2014 / 15 year had received an annual health check. The practice manager told us that there was an action plan in place to ensure there checks were completed for all patients on the register which included offering these patients appointments at specialist chronic disease clinics they had scheduled for 12 and 19 December. They also planned to arrange for the healthcare assistant to carry out some of the health checks.

Patients whose circumstances may make them vulnerable were discussed at clinical meetings. These included patients with new cancer diagnosis, and patients about whom there was a safeguarding concern. Together the clinical team discussed these patients and decided on the best course of action to support them. Some allied health professionals, such as health visitors and midwives, were based on the practice site, and their input was sought into the management of these cases.

The practice included equality training in its programme of mandatory staff training.

A side room was available adjacent to the reception area, which staff were able to use to hold private conversations with patients.

A separate telephone line was available for vulnerable patients to use, which allowed them quicker access to the GP practice.

The practice provides Violent Patient Scheme (VPS) DES. The VPS DES aims to provide a secure environment in which patients who have been violent or aggressive in their GP practice can receive general medical services. At the time of our inspection, the practice had 10 to 15 patients receiving care and treatment under the scheme. They had protocols and facilities in place to protect the patients and their staff. Vulnerable patients were coded on the electronic record system and had a named GP.