Background to this inspection
Updated
23 November 2016
Hayes Town Medical Centre is a GP practice based in Hillingdon in North West London area. The practice is based in a purpose built premises that is shared with other local NHS services.
The practice provides NHS primary medical services through an Alternative Provider Medical Services (APMS) contract to around 8500 patients in the local community. Prior to October 2014 the practice also had a contract to provide walk in services to patients. The practice is part of a larger company providing primary care and diagnostic services across England. Staff at this practice were supported by a regional business manager and medical director.
The practice population has a higher proportion of younger adults and children and lower proportions of older people. The local area has relatively high levels of deprivation compared to the English average. The practice serves a culturally diverse population, with the majority of patients being from an Asian background. According to the practice they have a high number of young students and a very mobile population.
The practice is registered as a private company with the Care Quality Commission (CQC) to provide the regulated activities of: treatment of disease, disorder or injury; diagnostic and screening procedures; family planning services and maternity and midwifery services.
The practice employs two female and two male salaried male GPs working a total of 33 sessions between them. The practice has a full time practice manager; the rest of the practice team consists of a practice nurse working two days per week and five administrative staff consisting of medical secretaries, reception staff, clerks and a typist.
The practice was currently open five days a week from 8am-:8pm on Mondays- Fridays. On Saturday and Sundays the practice is open from 9am until 2pm.Consultation times were 8am until 12:30pm and 3:30pm until 8pm.
When the practice is closed, the telephone answering service directs patients to contact the out of hours provider.
Updated
23 November 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Hayes Town Medical Centre on 22 September 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:
- Ensure the practice improves and responds to the national GP patient survey results in lower scoring areas including responses related to nursing care at the practice.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
23 November 2016
The practice is rated as good for the care of people with long-term conditions.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Performance for patients with diabetes, on the register, in whom the last blood test was 62 mmol/mol or less in the preceding 12 months, was lower to the national average (practice 62%; national 78%).The practice were working in partnership with the community specialist diabetic teams to make improvements and the 2015/2016 figures had improved.
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Longer appointments and home visits were available when needed.
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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.
Families, children and young people
Updated
23 November 2016
The practice is rated as good for the care of families, children and young people.
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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 A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
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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.
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The practice’s uptake for the cervical screening programme was 79%, which was comparable to the CCG average of 78% and the national average of 82%.
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Appointments were available outside of school hours and the premises were suitable for children and babies.
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We saw positive examples of joint working with midwives, health visitors and school nurses.
Updated
23 November 2016
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
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Systems were in place to identify and assess patients who were at high risk of admission to hospital and the practice would call them after discharge to ensure they were receiving appropriate follow up care.
Working age people (including those recently retired and students)
Updated
23 November 2016
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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.
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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.
People experiencing poor mental health (including people with dementia)
Updated
23 November 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
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The practice carried out advance care planning for patients with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
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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.
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Staff had a good understanding of how to support patients with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
23 November 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
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The practice offered longer appointments for patients with a learning disability.
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The practice regularly worked with other health care professionals in the case management of vulnerable patients.
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The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
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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.