8 March 2019
Paxton Green Group Practice operates from a single site in the south London Borough of Lambeth. It is one of 42 GP practices in the Lambeth Clinical Commissioning Group (CCG) area. There are approximately 19,700 patients registered at the practice and it is a training practice for qualified doctors seeking to become GPs.
The practice is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury. The practice has a personal medical services (PMS) contract with the NHS.
There are 11 GPs working at the practice. Six are partners (four male and two female) and five are salaried (four female and one male). The all female nursing team consists of six practice nurses, one of whom is a non-medical prescriber, and a primary care assistant practitioner. The clinical team also includes a clinical pharmacist (part time) and an associate physician. There is a full support team comprising Practice Manager, Assistant Practice Manager, IT manager and a total of 19 administrative and reception staff.
Nationally reported data shows the practice has a larger than average population of registered patients aged between 25 and 40 years. Data also shows that income deprivation is at point three of a scale 1 to 10 (with 10 being least deprived). Ethnicity breakdown of the practice population is 59% white, 25% black, 8% mixed race, 6% Asian and 2% other race.
The practice is open between 8am and 7pm every weekday. A daily Walk & Wait Clinic (WAWC) is available for patients wishing to be seen on the day. In the afternoons bookable appointments are available between 2.00pm and 6.00pm. Extended hours are offered on Monday and Wednesday from 6.30pm to 8.00pm, and Saturday from 8.00am to 11.00 am.
The out-of-hours service is provided by a co-operative of local GPs, for which some of the practice GPs work shifts. The details of which can be found on the practice website.
8 March 2019
We carried out an announced comprehensive inspection at Paxton Green Group Practice on 31 January 2019 as part of our inspection programme. The practice had been previously rated as good when we carried out the first inspection in November 2015. Our inspection team was led by a Care Quality Commission (CQC) Inspector and included a GP specialist advisor.
Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.
We have rated this practice as good overall.
This means that:
• Patients were protected from avoidable harm and abuse and that legal requirements were met.
• Patients had good outcomes because they received effective care and treatment that met their needs.
• Patients were supported, treated with dignity and respect and were involved as partners in their care.
• People’s needs were met by the way in which services were organised and delivered.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.
We rated the practice as outstanding for providing responsive services because there were innovative approaches to providing integrated person-centred care including:
- Time bank offered at the practice for patients to drop in and socialise or learn new skills. This offered older patients an opportunity to avoid social isolation.
- Significant attention to patient feedback and thriving PPG. The PPG was instrumental in developing the ask the GP facility on the practice website. This reduced the need for appointments by providing patients with a 48 hour response to their health questions. It also enabled GPs to arrange prompt appointments if the question asked required a consultation.
- A daily telephone advice line overseen by the doctors. This focussed on advice for older patients, their relatives and/or carers.
- A prostate cancer screening service including ultrasound and urine flow tests at the practice. Providing opportunity for early diagnosis without the need to travel to hospital and onward referral for prompt treatment.
- A dedicated medicine query telephone line run by a practice pharmacist where queries were responded to the same day.
- Prompt referral to community and voluntary groups with evidence of older patients receiving quick support from such groups to reduce the risk of hospital admission. The practice had the highest referral rate to support groups for the elderly within the clinical commissioning group (CCG) area. CCG benchmarking data showed the practice as one of the lowest for hospital admissions and accident and emergency attendance.
- On site pilot clinics with psychiatric nurses for patients with long term mental health problems and for early screening for dementia, leading to earlier diagnosis and support.
- There was access to a mental health specialist at the practice every day.
- Patients with long term mental health needs had a named nurse for continuity of care.
We rated the population groups as good with the exceptions of both Older People and People experiencing poor mental health (including those with dementia) which were rated outstanding. This is because the practice had introduced additional services, as described above, which focused on ensuring appropriate and timely support for these groups of patients. The practice also made additional efforts to provide continuity of care for these groups.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice