Wood Lane Medical Centre

Updated 25 April 2017

Wood Lane medical Centre is located in a converted terraced house in Havering and is a part of NHS Havering Clinical Commissioning Group (CCG). The practice has good transport links and there is free parking on surrounding roads.

There are 8200 patients registered at the practice, 50% of patients have a long term condition which is similar to the CCG and national average of 51% and 54%. The practice has a lower number of unemployed patients than the CCG and national average at 2% compared to 4% and 5% retrospectively.

Based on data available from Public Health England (PHE), the practice is located in one of the forth most deprived decile areas. The level of deprivation within the practice population group is rated as four on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest.

The practice has two male and two female GP partners and three sessional GPs who complete a combined total of 31 sessions per week, there are three female practice nurses including a nurse Independent Prescriber who complete 22 sessions per week and a practice pharmacist. There is a practice manager and 10 reception/administration staff members.

The practice operates under a Personal Medical Services (PMS) contract (a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract).

The practice is open Monday to Friday between 8am and 6:30pm except on a Wednesday when it opens at 7am. The practice also opens on one Saturday per month from 9:30am to 11:15am. Phone lines are answered from 8am and appointment times are as follows:

• Monday 8am to 12pm and 1:30pm to 6:45pm.

• Tuesday 8am to 12:15pm and 2pm to 7:45pm.

• Wednesday 7am to 12:20pm and 2pm to 6pm.

• Thursday 8am to 12:20pm and 3pm to 5:50pm.

• Friday 8am to 12:20pm and 2pm to 6:20pm.

• Saturday (one per month) 9:30am to 11:15pm.

The locally agreed out of hours provider covers calls made to the practice whilst the practice is closed.

Wood Lane Medical Centre operates regulated activities from one location and is registered with the Care Quality Commission to provide treatment of disease, disorder or injury, surgical procedures, diagnostic and screening procedures, family planning and maternity and midwifery services.

Updated 25 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wood Lane Medical Centre on 19 January 2017. 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 a system in place for reporting and recording and sharing learning from significant events.
• The practice offered extended hours on two evenings and one morning per week and was open one Saturday per month for patients who could not attend the practice during normal working hours.
• The practice had clearly defined and embedded systems to minimise risks to patient safety, however fire drills were not carried out.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment with a named GP and 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 the partners and management.
• The practice proactively sought feedback from staff and patients, which it acted on. There was an active patient participation group.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• The practice provided minor surgery and gynaecological services for patient from local practices.

The areas where the provider should make improvement are:

• Review systems for identifying and recording carers to ensure appropriate support is provided to them.

• Follow through with plans for the external legionella risk assessment.

• Review fire safety systems to include regular fire drills.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 April 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was comparable with the CCG and national averages. For example 82% of patients on the diabetes register had a blood pressure reading of 14/80 mmHg or less in the preceding 12 months, which was comparable with the CCG and national average of 78%. Exception reporting was 5%, which was lower than the CCG and national average of 9%.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans and medicines were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• All these patients had a named GP and there was a system to recall patients for 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 25 April 2017

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

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.

• Childhood immunisation rates for the vaccinations given were comparable to the national averages. There are four areas where childhood immunisations are measured; each has a target of 90%, the practice achieved between 84% and 85% in these areas. These measures can be aggregated and scored out of 10, with the practice scoring 8.5 (compared to the national average of 9.1).

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

• The practice provided support for premature babies and their families following discharge from hospital, the practice liaised with the health visitor and provided home visits when necessary.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 25 April 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• Patients aged over 75 were automatically booked a double appointment to allow sufficient time for their complex medical and social needs to be met.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients and where necessary their carers in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Where older patients had complex needs, the practice shared summary care records with local care services.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible; this included providing information about local social and exercise groups.

Updated 25 April 2017

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

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours and Saturday appointments.

• 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.

• The practice offered telephone consultations at differing times throughout the day.

• The practice was a part of the local HUB which provided GP and nurses appointments on weekday evenings and on weekends when the practice was closed.

Updated 25 April 2017

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

• The practice carried out advance care planning for patients living with dementia.

• Alerts were put in the patient notes to highlight these patients to staff members so that appropriate support could be provided at each point of contact.

• 95% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the CCG average of 82% and the national average of 84%. Exception reporting was 9% compared to the national average of 7%.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia; these patients were given double appointments and priority access to appointments.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive agreed care plan documented in their record compared to the CCG average of 91% and the national average of 89%. Exception reporting was 18% compared to the national average of 13%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 25 April 2017

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.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• The practice offered longer appointments and priority 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.

• All staff had received vulnerable adults training.