Archived: The Tulse Hill Practice

Updated 16 April 2015

The Tulse Hill Practice is based in the London Borough of Lambeth. The practice provides primary care services to 7,400 patients.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of: diagnostics and screening procedures; family planning; maternity and midwifery services; and treatment of disease, disorder or injury.

The practice is located in an area of high deprivation where the life expectancy for men and women is 76 years and 82 years respectively, which is in line with the national average. The practice serves a culturally diverse population, including British, African, Caribbean, White Other, Indian and Chinese patients. According to the practice they have a high number of young students and a very mobile population.

The practice is located in a purpose built building. The practice has three senior female partners and three salaried female GPs. The practice employs two practices nurses with one of them working full time and the other two days per week. A healthcare assistant is also available for 16 hours per week and five administrative staff and the practice manager.

The practice holds a Personal Medical Services (PMS) contract for the delivery of general medical services. Personal Medical Services (PMS) agreements are locally agreed contracts between NHS England and a GP practice. PMS contracts offer local flexibility compared to the nationally negotiated General Medical Services (GMS) contracts by offering variation in the range of services which may be provided by the practice, the financial arrangements for those services and the provider structure (who can hold a contract).

Appointments were available from 08:00 am to 18:30 pm on weekdays. Extended hours were offered on Wednesdays until 19:30 pm. The practice also offered Saturday appointments once a month from 09:00 am until 12:00 noon.

The practice has opted out of providing out-of-hours services to their own patients. A local out of hours service, SELDOC, is used to cover emergencies.

Updated 16 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Tulse Hill Practice on 11 November 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for all the population groups including older people; people with long term conditions; mothers, babies, children and young people; the working age populations and those recently retired; people in vulnerable circumstances and people experiencing poor mental health.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Risks to patients were assessed and well managed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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.

• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 April 2015

The practice is rated as good for the population group of people with long term conditions. Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed longer appointments and home visits were available. All these patients had a named GP and structured annual reviews to check their health and medication needs were being met. For those people with the most complex needs the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 16 April 2015

The practice is rated as good for the population group of families, children and young people. Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk, such as those, who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us and we saw evidence that children and young people were treated in an age appropriate way and recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. There were baby change facilities, space for prams and buggies. We were provided with good examples of joint working with midwives, health visitors and school nurses. Emergency processes were in place and urgent referrals made for children and pregnant women who had a sudden deterioration in health.

Updated 16 April 2015

The practice is rated as good for the care of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example in dementia and end of life care. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs and home visits.

Updated 16 April 2015

The practice is rated as good for the population group of the 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 offer continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening which reflects the needs for this age group.

Updated 16 April 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). All patients on the practice list identified as having poor mental health had received an annual physical health check in the 2013/2014 time period. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had in place advance care planning for patients with dementia.

The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations including MIND and SANE. The practice had a system in place to follow up on patients who had attended accident and emergency for urgent care and where there may have been underlying mental health needs. Staff had received training on how to care for people with mental health needs and dementia.

Updated 16 April 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours. All patients on the practice list identified as having learning difficulties had received an annual health check in the 2013/14 time period.