• Doctor
  • GP practice

Dr Evans & Partners

Overall: Good

Florence Road Surgery, 26 Florence Road, Ealing, London, W5 3TX (020) 8567 2111

Provided and run by:
Dr Evans & Partners

Latest inspection summary

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Background to this inspection

Updated 5 July 2016

Dr Evans and Partners is a well-established GP practice based in two separate sites; the main surgery at Florence Road and the branch surgery at Bramley Road which are both situated within the London Borough of Ealing. Registered patients can access either surgery. The practice lies within the administrative boundaries of Ealing Clinical Commissioning Group (CCG) which is part of North West London Healthcare. The practice is a member of South Central Ealing GP network within Ealing GP Federation of seven GP networks and 79 GP practices. The practice provides primary medical services to approximately 15,900 patients across both practice sites and holds a core General Medical Services Contract and Directed Enhanced Services Contracts.

The main surgery at Florence Road is situated close to Ealing Common and Ealing Broadway with the premises owned by three of the GP partners. The building is a converted Victorian four storey semi-detached house with ten consulting rooms spread across three floors with lift access between the basement and the ground floor. The reception and waiting area are located on the ground floor with wheelchair access to the entrance of the building. Bramley Road Surgery is situated in South Ealing with the premises leased from a former GP provider. The building is a converted 1930’s end of terrace house with three consultation rooms, reception and waiting area all situated on the ground floor with wheelchair access. Both surgeries have good transport links by bus and rail services and car parking is available off site.

Florence Road Surgery is approved as a training practice and hosts two male GP registrars. The practice also provides training for medical students.

The practice population is ethnically diverse and there is a wide social mix of patients residing in a variety of housing accommodation. Due to population mobility in the area the practice experiences a high volume of new registrations. There is a higher than the national average number of patients between 25 and 44 years of age and a lower than the national average number of older patients between 65 and 85 years plus. The practice area is rated in the fourth lest deprived decile of the national Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have greater need for health services.

The practice is registered with the Care Quality Commission to provide the regulated activities of diagnostic & screening procedures, family planning, maternity & midwifery services, surgical procedures and treatment of disease disorder & injury.

The practice team comprises of three male GP partners, two female GP partners, two female salaried GPs, one male salaried GP who collectively work a total of 52 clinical sessions per week and two male GP registrars. They are supported by one full time nurse practitioner prescriber, one full time practice nurse, one part time practice nurse, three healthcare assistants, phlebotomist, practice manager, administration manager, reception manager, 15 administration staff and 11 receptionists/GP personal assistants. A prescribing clinical pharmacist and two pharmacy technicians are sub-contacted by the practice.

Florence Road Surgery opening hours are 8.00am to 6.30pm Monday to Friday. The practice is closed for lunch between 12.30pm and 1.30pm. Appointment times are from 8.00am to 12.20pm and 4.00pm to 6.30pm Monday to Friday. Extended hours are offered for pre-booked appointments from 7.30am to 8.00am and 6.30pm to 8.30pm on Tuesday and 7.30am to 8.00am on Wednesday. There are dedicated same day and pre-bookable appointment slots for adults and children under 16 years of age Monday to Friday. Nurse triage appointments are available daily from 8.00am to 12.30pm.

Bramley Road Surgery opening hours are 8.00am to 6.30pm Monday to Friday. The practice is closed for lunch between 12.30pm and 1.30pm. Appointment times are from 8.00am to 12.20pm and 4.00pm to 6.30pm Monday to Friday. Extended hours are offered for pre booked appointments from 6.30pm to 8.00pm on Monday and Thursday and from 8.00am to 12.00pm on Saturday. There are dedicated same day and pre-bookable appointment times for adults and children under 16 years of age Monday to Friday.

The out of hours services are provided by an alternative provider. The details of the out-of-hours service are communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.

The practice provides a wide range of services including chronic disease management, antenatal and postnatal care and over 75’s health checks. The practice also provides health promotion services including, cervical screening, childhood immunisations, contraception and family planning.

Overall inspection

Good

Updated 5 July 2016

We carried out an announced comprehensive inspection at Dr Evans & Partners which provides clinical services from two sites; Florence Road the main surgery and the branch surgery at Bramley Road, which are both situated in the London Borough of Ealing. We visited both of these locations as part of the inspection on 29 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.
  • The practice had a dedicated clinical pharmacy team that ensured robust processes in place for repeat prescription management.

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said staff were caring, supportive, and friendly and treated them with dignity and respect.

  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients 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.
  • 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.
  • There was a strong focus on continuous learning and improvement at all levels.

We saw areas of outstanding practice:

  • Clinical pharmacist expertise to support GPs in the management of patients with chronic disease and elderly patient care. Attendance by the clinical pharmacist at local nursing home ward rounds had contributed to a 91% reduction of medication errors.

The areas where the provider should make improvement are:

  • Ensure that DBS checks are completed for all staff who may be required to undertake chaperone duties.

  • Ensure that fridge temperature monitoring records are complete.

  • Complete annual staff appraisals for administration staff.

  • Ensure administrative staff attend basic life support training in accordance with national guidance.

  • Improve vaccine stock records with inclusion of expiry dates and running stock totals.

  • Implement proposed procedures to identify carers to ensure they are provided with support.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

People with long term conditions

Good

Updated 5 July 2016

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

  • The practice offered nurse led chronic disease management clinics and all patients were invited for annual review.

  • Data from the Quality Outcome Framework for 2014/2015 showed the practice was performing in line with local and national averages for scores in chronic disease management.

  • Patients with newly diagnosed chronic conditions at routine health checks were reviewed promptly by the appropriate GP for education and introduction to disease monitoring.

  • Home visits were available for patients unable to attend the practice due to illness or immobility, including nurse led anticoagulation testing and flu vaccinations.

  • There were weekly appointments available with the clinical pharmacist for medication review for patients with complex medication needs and polypharmacy.

  • The practice offered in-house electrocardiograms (ECGs) and 24 hour blood pressure monitoring.

  • The practice held regular multi-disciplinary team meetings with the community nursing team to discuss the needs of patients with complex medical needs and update care plans.

Families, children and young people

Good

Updated 5 July 2016

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

  • There was a named lead for safeguarding children, staff had received role appropriate child protection training and understood their responsibilities to raise concerns. The practice held regular safe guarding meetings with the health visitor team to discuss patients on the safeguarding list and identify children at risk.

  • Dedicated appointments were available for children including after school hours slots.

  • The clinical pharmacist provided advice on paediatric medicine doses when required.

  • Paediatric phlebotomy services were available for children aged five to fifteen years old at Bramley Road Surgery.

  • The practice had a policy to refer all children for specialist opinion if they had consulted on three occasions within a short period of time.

  • The practice offered childhood immunisations in line with national guidance and uptake rates were comparable to national averages.

  • GP and nurse led contraception services were available, including insertion of intra-uterine contraceptive devices and implants.

  • The practice provided clinical facilities for annual screening for cardiac risk in the young for patients registered at the practice and from the wider Ealing community.

Older people

Good

Updated 5 July 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. All patients had a named GP to co-ordinate care.

  • The practice was responsive to the needs of older people, and offered home visits for patients unable to attend the practice due to illness or immobility, including nurse led anticoagulation testing and flu vaccinations.

  • The practice made use of local transport services to improve access to the surgery for older patients.

  • There were weekly appointments available with the clinical pharmacist for medication reviews for older patients with complex medication needs and polypharmacy.

  • The practice provided comprehensive services to a local nursing home for patients with complex needs. They conducted twice weekly joint ward rounds with a named GP for continuity of care and the practice clinical pharmacist. The clinical pharmacist provided medication review and advice for patients receiving medications through . The practice also provided services to two other local nursing homes with weekly visits by a GP. Since the inception of this service there had been a 91% decrease in prescribing errors.

  • The practice held regular multi-disciplinary team meetings with the community nursing team to discuss the needs of older patients with complex medical needs and update care plans.

  • The practice used risk stratification tools to identify older patients at high risk of hospital admission and invited them for review to create and update integrated care plans aimed at reducing this risk.

Working age people (including those recently retired and students)

Good

Updated 5 July 2016

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

  • The practice offered extended hour appointments for patients unable to attend during normal working hours. Daily telephone GP consultations were also available.

  • There was the facility to book appointments and request repeat prescriptions online.

  • There were dedicated appointment slots three times a week for local students from the university that could be booked through the student welfare service or by the patient directly. The practice had worked with the local University of West London to offer medical advice and support. For example, one of the GPs had been involved in producing guidelines during the Ebola crisis as there were a large number of overseas students from areas at high risk.

  • Patients were able to receive travel vaccinations available on the NHS as well as those only available privately.
  • The practice offered new patient and NHS Health checks and any issues identified at these checks were followed up on appropriately.
  • There was a Health Care Assistant led smoking cessation service available on Saturday mornings.

People experiencing poor mental health (including people with dementia)

Good

Updated 5 July 2016

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

  • The practice had engaged with the Shifting Settings of Care scheme to support patients experiencing poor mental health transferring from secondary care to community mental health services. The practice worked with the Primary Mental Health Worker to support these patients in the community.

  • GPs had daily access to the local psychiatric liaison consultant lead advice line for support when managing patients experiencing poor mental health.

  • The practice opportunistically screened patients for dementia and referred on to local memory services where appropriate.

  • Quality Outcome Framework data from 2014/2015 showed the practice was performing in line or above national averages for mental health indicators.

People whose circumstances may make them vulnerable

Good

Updated 5 July 2016

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

  • There was a named lead for safeguarding vulnerable adults and staff had received training and were aware of their responsibilities to raise concerns.

  • Double appointments were available for vulnerable patients and those who required an interpreter.

  • Patients with learning disabilities were invited for annual review at dedicated joint GP and nurse led clinics.

  • The practice provided primary medical care to patients in a local women’s refuge and provided care of asylum seekers and young people in supported accommodation at a local hostel.

  • The practice list was open to patients with no fixed address to register and access medical services.

  • The practice held bi-weekly alcohol and substance misuse clinics for patients requiring support with these issues.