Background to this inspection
Updated
7 November 2019
The Great West Surgery is located in Hounslow, West London. The practice is located in a purpose-built medical centre which is currently co-located with a community pharmacy.
The Great West Surgery is a branch surgery. The provider also runs a main surgery in Hounslow under the same contract. The main surgery is known as Heston Practice and is located at Cranford Lane, Hounslow, TD5 9EW. Patients are free to book appointments at either site.
The practice is run by Hounslow Medical Centre (also known as HMC Health Hounslow) which also runs four other primary care practices in Hounslow.
The provider provides NHS services through an Alternative Provider Medical Services (APMS) contract to around 8900 patients. It took over the contract from another GP provider on a temporary basis from 1 May 2019.
The practice’s clinical team is led by two clinical directors (partners), a clinical lead GP (male, full-time) and local practice managers . The practice provides 36 GP sessions per week across the main and branch site through a team of regular sessional GPs and the lead GP. Male and female GPs are available. The practice also employs part-time practice nurses and health care assistants. Clinical pharmacist support is available across the practice group. There is a team of administrators/receptionists.
The practice is open Monday to Friday from 8am to 6.30pm and on Saturday morning from 8am to 12pm. The practice offers online appointment booking and an electronic prescription service. The GPs carry out home visits for patients whose health condition prevents them attending the surgery. Out of hours primary care services are provided by a contracted service. Information is provided to patients about how to access this service.
The practice has a relatively large working age population and numbers of very young children and babies. There are relatively fewer older children, teenagers and older patients in its population compared to the national average. The locality tends to the national average in terms of deprivation levels and life expectancy. The population is diverse with just over half the local population being of black and minority ethnic backgrounds.
The practice is registered with the CQC to carry out the following regulated activity: treatment of disease; disorder or injury.
Updated
7 November 2019
We carried out an announced comprehensive inspection at the Great West Surgery on 30 August 2019 as part of our inspection programme.
This practice has been managed by the current provider on a temporary basis since 1 May 2019. We previously inspected Heston Practice on 6 December 2018 when it was run by a different provider. At that inspection, we rated the service as inadequate for safe, effective, responsive and well-led care. We rated the service as requires improvement for being caring. The service was rated as inadequate for all population groups. The service was placed into special measures for six months from 19 February 2019.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations
- our inspection included visits to both the main and branch surgery sites.
We have rated this practice as good overall. We have rated it as good for all population groups except for the working age people; and the families, children and young people population groups which we rated as requires improvement.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
We rated the working age people; and, the families, children and young people population groups as requires improvement because the cervical screening and childhood immunisation uptake rates were not yet in line with the relevant national targets.
Whilst we found no breaches of regulations, the provider should:
- Proactively work with the landlord to ensure that all environmental risks are being effectively managed.
- Monitor the effectiveness of actions to increase uptake of cervical screening.
- Continue efforts to increase the uptake of childhood immunisations.
- Set up a functioning website for patients with information about available services.
The provider had taken over the service on a temporary basis from 1 May 2019. Since taking over, it had reviewed the issues raised at the last inspection. It had put in place systems to manage identified risks and provide care in line with national and local guidelines. At the time of our inspection, there were now clear governance structures including visible management arrangements at both the surgery and branch level. Staff and patients were engaged in practice development and told us that the service had improved.
I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care