Chiswick Family Doctors Practice

Updated 19 June 2017

The Chiswick Family Practice is located in the London Borough of Hounslow, and provides a general practice service to around 3500 patients from a shared community health centre.

The practice is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of: treatment of disease, disorder or injury; surgical procedures; diagnostic and screening procedures; family planning services; and maternity and midwifery services at one location.

The practice has a General Medical Services (GMS) contract and provides a full range of essential, additional and enhanced services including maternity services, child and adult immunisations, family planning, sexual health services and minor surgery.

The practice has two GP partners working eight sessions, a salaried GP working five sessions and a locum GP covering four sessions.

There is a good mix of female and male staff. The practice has a part time practice manager. The rest of the practice team consists of one part time practice nurse, one part time health care assistant and four administrative staff consisting of medical secretaries, reception staff, clerks and typist.

The practice is open five days a week. Mondays and Fridays 8am to 6:30pm, Tuesdays from 8am to 7pm, Wednesdays from 8am to 8pm and Thursdays from 8am to 12:30pm. Face to face consultations in the mornings are from 8:30am to 11:30am and in the afternoons from 2:30pm to 6:30pm on Mondays and Fridays and until 7pm on Tuesdays, and 7:30pm on Wednesdays.

When the practice is closed, the telephone answering service directs patients to contact the out of hours provider.

Updated 19 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chiswick Family Doctors Practice on 2 February 2016. The overall rating for the practice was good. However, within the key question safe an area was identified as ‘requires improvement’, as the practice was not meeting the legislation for Safe care and treatment.

The practice was issued a requirement notice under Regulation 12, Safe care and treatment. The full comprehensive on 2 February 2016 can be found by selecting the ‘all reports’ link for the Chiswick Family Doctors Practice on our website at www.cqc.org.uk.

This inspection was a focused desk based review carried out on 31 March 2017 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified in our previous inspection on 2 February 2016. This report covers our findings in relation to those requirements and also any additional improvements made since our last inspection.

Overall, the practice is rated as good.

Our key findings were as follows:

•  The practice had ensured they had oxygen on site to adequately deal with emergencies.
• The practice supplied an action plan and a range of documents which demonstrated they are now meeting the requirements of Regulation. Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 April 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.

• 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 12 April 2016

The provider was 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.

• 76% of patients diagnosed with asthma, on the register, who had an asthma review in the last 12 months was comparable to the national average.

• 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 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 midwives, health visitors and school nurses.

Updated 12 April 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 .

Updated 12 April 2016

The provider was 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.

Updated 12 April 2016

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

• 94% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• 94% of patients diagnosed with schizophrenia, bipolar and other mental health conditions had a care plan reviewed in the last 12 months, which was higher than the national average.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 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 12 April 2016

The provider was 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 multi-disciplinary teams in the case management of vulnerable people.

• 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.