Archived: Waterloo Health Centre

Updated 30 January 2017

Waterloo Health Centre is based five minutes’ walk from Waterloo train station. The practice is also five minutes from St Thomas’ Hospital. The practice list size is approximately 11,300. The practice population is diverse, with a predominantly young working population. Eighty five percent of the patient population is less than 50 years old. Life expectancy for males in the practice is 77 years and for females 84 years. Both of these are in line with the Lambeth CCG and national averages for life expectancy. The practice has a higher than average number of male and female patients aged between 20-39 years. The practice has lower than average numbers of both male and female patients aged 0-19 and 45-85 years old.

The practice facilities include nine consultation and treatment rooms and a patient waiting room. The consultation rooms are on the ground floor. The premises are wheelchair accessible and there are facilities for wheelchair users including an accessible toilet. There are lowered reception desks to enable wheelchair users to speak with staff at the reception. There is a hearing loop for patients with hearing impairments. Baby changing facilities are available.

The staff team compromises of two male and two female GP partners working a total of 14 sessions. There were three salaried GPs (two female and one male) working 18 sessions. The practice was a training practice and had one registrar who worked six sessions per week. Other staff included two practice nurses (both female), a health care assistant (female), seven receptionists/administration staff, and a practice manager.

The practice is open between 8am to 6.30pm Monday to Friday. They offer extended hours from 6.30pm to 8.15pm on Wednesday when appointments are available from 6.30pm to 7.50pm. When the practice is closed patients are directed (through a recorded message on the practice answer machine) to contact the local out of hours service. Information relating to out of hours services is also available on the practice website. This includes details of the local walk in service, pharmacy services and mental health services.

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; diagnostic and screening; family planning; maternity and midwifery services and surgical procedures at one location.

Updated 30 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Waterloo Health Centre on 12 October 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.
• Risks to patients were assessed and well managed.
• 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 they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• 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 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.

The areas where the provider should make improvement are:

• Review Portable appliance testing (PAT) to ensure all equipment is validated and checked.

• Review the business continuity policy to include all staff contact details.

• Display interpreter information for patients whose first language is not English.

• Install an emergency cord in the disabled toilet.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 30 January 2017

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.

• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less was 85%, which was 5% above the Clinical Commissioning Group (CCG) average and 4% above the national average. The exception rate for the practice was 9%, the CCG was 9% and national rate was 12%.

• 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 30 January 2017

The practice is 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 Accident and Emergency (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• 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.

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

• GP and midwife appointments were offered for antenatal care, including a weekly baby clinic, six week post-natal checks, Health Visitor reviews and childhood immunisation.

• We saw positive examples of joint working with midwives, health visitors

Updated 30 January 2017

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 older people had a named GP. The named GP was responsible for repeat prescribing, dealing with paperwork and leading on home visits for all their allocated patients.

• The practice participated in the unplanned admissions direct enhanced service.

• The practice undertook Holistic Needs Assessments, predominantly in the home environment to proactively identify health problems early, including dementia screening, and identifying hearing and vision problems.

Updated 30 January 2017

The practice is 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.

• The practice provided contraceptive reviews online.

• The practice supported a large working population; they offered out of area registration, this allowed patients to access care close to work.

• The practice had a large student population; they provided outreach registration days at the start of academic year in residences nearby, to educate students about accessing the NHS when they need to.

• They provided Sexual Transmitted Infection (STI) home testing packs.

• They provided instant Human Immunodeficiency Virus (HIV) testing at registration.

Updated 30 January 2017

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients 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.

• The practice had a psychologist and counsellor who attended weekly.

• All patients with chronic mental health problems including dementia had a named GP to ensure continuity.

Updated 30 January 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 homeless people, travellers and those with a learning disability.

• The practice offered annual health checks for patients with leaning disability and carers; patients would be contacted within their birthday month to ensure the check was completed.

• The practice offered a drop-in service each morning for any homeless patients to attend, they were not required to be registered at the practice, they would provide blood borne virus screening, vaccinations and health promotion.

• The practice held a weekly clinic with a shared care worker to support patients with drug and alcohol problems including substitution prescribing and monitoring closer to patients homes where possible.

• The practice offered longer 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 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.

• Translation services were available; however, the practice did not actively promote this, as there were no signs or leaflets advertising this.