Central London GP rated as Outstanding

The Care Quality Commission (CQC) has rated the Doctor Hickey Surgery in Westminster, Central London, as Outstanding following an inspection in May 2015.

Under CQC’s programme of inspections, all primary medical services in England are being given a rating according to whether they are safe, effective, caring, responsive and well led.

The full report from the Doctor Hickey Surgery inspection has been published on the CQC website.

The Doctor Hickey Surgery provides primary medical services to around 1,700 homeless people in the Westminster area. More than half of the 6,000 rough sleepers recorded every year throughout England are located in London. Around a third of this population are in Westminster, where the Doctor Hickey Surgery has been providing services for twenty seven years.

Patients told CQC inspectors that they were treated with compassion, dignity and respect and that they were involved in their care and decisions about their treatment. They said it was easy to get an appointment with a named GP or a GP of choice, and that there was continuity of care and appointments were always available on the same day.

Inspectors found that the surgery used numerous innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. The surgery worked closely with other organisations and with the local community in order to plan how services could be provided to ensure that they met people’s needs.

The surgery recognised that very few of their patients were employed, and that work was the main route out of poverty for many patients. Staff were committed to helping patients become healthy enough to work, and had formed partnerships with charitable organisations and Westminster University who provided support at the practice to assist patients who wished to gain employment. Training including English language lessons, Construction Skills Certification Scheme cards, cooking and IT qualification courses.

Inspectors saw that the surgery had over 275 patients being prescribed opiate substitutes, making them the largest single primary care provider of opiate substitute therapy in Westminster.

The surgery had recognised that substance and alcohol misuse were the key causes of health issues for homeless people, and responded to this issue by providing general medical services in local alcohol hostels, and ensuring that all substance misuse patients had a named GP and structured three monthly reviews to check that their health and medication needs were being met.

Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses, and that opportunities for learning from internal and external incidents were maximised.

CQC inspectors also found several areas of outstanding practice, including:

• The practice had a medical outreach project called the ‘Street Doctor Program’ which involved GPs and some practice staff carrying out night walks through the local streets and parks. They spoke with rough sleepers, identified their medical needs and addressed those needs in ways which were likely to improve both their general health and their ability to utilize general homelessness services, with the ultimate aim of permanent resettlement.
• The practice employed an in-house drug and alcohol counsellor, available to patients five days a week, and a general counsellor available one day a week. Both counsellors saw both appointment and walk-in patients, with up to nine patients being seen each day.
• The practice had entered into a partnership with a local food business that provided free sandwiches every day for surgery patients. Many patients told inspectors that often this was only food they would eat for several days.

Ursula Gallagher, Deputy Chief Inspector of General Practice said:

"We found that the Doctor Hickey Surgery is providing an Outstanding service, particularly for people whose circumstances may make them vulnerable.

“We were particularly impressed with the practice’s work to initiate positive service improvements for local patients and the commitment of all staff to continuously seek improved outcomes for local homeless people.

“Staff demonstrated a sound understanding of the differing needs of their patients and reflected these needs when planning and delivering services. This is a fantastic example of what outstanding care looks like.”

Ends

For further information please contact Yetunde Akintewe, CQC Regional Engagement Manager, on 07471 020 659. For media enquiries, journalists wishing to speak to the press office outside of office hours can find out how to contact the team here. For general enquiries, please call 03000 61 61 61.