Star Lane Medical Centre

Updated 18 September 2017

The Star Lane Medical Centre is situated within the NHS Newham Clinical Commissioning Group (CCG). The practice provides services to approximately 14,300 patients under a Personal Medical Services (PMS) contract and a full range of enhanced services including minor surgery, child and travel vaccines, and family planning including coil fitting. It is registered with the Care Quality Commission to carry on the regulated activities of maternity and midwifery services, family planning services, treatment of disease, disorder or injury, surgical procedures, and diagnostic and screening procedures.

The practice teaches GP students and trains qualified GP registrars. The staff team two GP partners, (one female working six sessions, and one male working eight sessions per week), five salaried GPs (three female working a total of 18 sessions per week, and two male working a total of 16 sessions per week), six regular locum GPs working 18 sessions per week, a full time female nursing team (practice nurse, trainee practice nurse and health care assistant), a full time pharmacist, a practice manager and assistant practice manager (both full time), and a team of reception and administrative staff all working a mixture of full time and part time hours.

The practice premises are purpose built over two storeys with lift access to the first floor. Their cores opening hours are between 8:00am to 6.30pm every weekday. GP appointments are available from 8.00am to 6.30pm and include home visits, telephone consultations and online pre-bookable appointments. Urgent appointments are available for patients who need them. The practice provides an on-site extended hour’s service from 7.40am to 8.00am every Monday and from 6.30pm until 9.00pm on Wednesdays. Further (off-site) extended hours are provided through a network collaboration of local practices every weekday from 6.30pm to 9.00pm and on Saturday from 9.00am to 1.00pm. Patients telephoning when the practice is closed are transferred automatically to the local out-of-hours service provider.

Information published by Public Health England rates the level of deprivation within the practice population group as one on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The practice has a higher percentage than national average of people whose working status is unemployed (7% compared to 4% nationally), and a lower percentage of people over 65 years of age (8% compared to 17% nationally).

Updated 18 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 18 August 2016. The overall rating for the practice was good. However, a breach of legal requirements was found during that inspection within the safe domain. After the comprehensive inspection, the practice sent us evidence and actions detailing what they would do to meet the legal requirements. We conducted a focused inspection on 10 August 2017 to check that the provider had followed their plans and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 18 August 2016 we found the following area where the practice must improve:

• Maintain effective arrangements for infection control and premises and equipment cleanliness and safety.
• Establish effective systems and processes to identify and mitigate risks to patient’s safety.

Our previous report also highlighted the following areas where the practice should improve:

• Implement systems to ensure all staff are trained in accordance with their role.
• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.
• Ensure premises restoration and decoration works are followed through.
• Review or evaluate arrangements for patient’s telephone access and information leaflet.
• Improve entrance doors arrangements to the baby clinic and first floor waiting room.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 10 August 2017 we found:

• Arrangements for infection control and premises and equipment cleanliness and safety were effective.
• Premises restoration and decoration works had been undertaken, a new door closer was fitted to the baby clinic and first floor waiting room.
• Systems and processes were in place to identify and mitigate risks to patient’s safety and to ensure staff were trained in accordance with their role.
• Patients with caring responsibilities were identified and recorded to ensure their appropriate information, advice and support.
• Arrangements for patient’s telephone access and information had been reviewed and updated.​

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 September 2016

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.
• Performance for diabetes related indicators was similar to the national average. For example, the percentage of patients on the diabetes register with a record of a foot examination and risk classification within the preceding 12 months was 95% compared with the national average of 88%.
• 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.
• The practice had encouraged its patients to enter a “beat the street” initiative (a walking, cycling and running community game where patients use a touch card to track their progress in competition within and between neighbouring boroughs). Ninety-four of its patients participated and had second for activity points on the local leader board.

• On site services included phlebotomy and diabetes clinics with initiation and management of “gliptins” and insulin, ECGs and phlebotomy. (Phlebotomy is blood sample collection, an ECG or “electrocardiogram” is a test which measures the electrical activity of your heart's rhythm and activity, gliptins are a medicine that can be used to treat diabetes mellitus type 2, insulin is a hormone which regulates the amount of glucose in the blood).

Updated 28 September 2016

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 A&E attendances.
• Childhood immunisation rates were comparable to CCG averages and ranged from 75% to 92% (CCG ranged from 82% to 94%) for under two year olds; and from 71% to 95% (CCG ranged from 82% to 94%) for five year olds.
• 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.
• The practice’s uptake for the cervical screening programme was 83%, which was comparable to the CCG average of 81% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives and there was twice monthly on site baby clinic run by health visitors.

76% of patients diagnosed with asthma, on the register had an asthma review in the last 12 months which was comparable to 78% within the CCG and 75% nationally.

Updated 28 September 2016

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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The percentage of patients with rheumatoid arthritis, on the register, who had had a face-to-face annual review in the preceding 12 months was 98% (CCG average 91% and national average 91%).
• Performance for treatment of stroke and Transient ischaemic attacks (TIAs), known as 'mini stroke' was 96% (CCG average 94% and national average 97%)
• The practice provided on site community anticoagulation for atrial fibrillation (AF). (Anticoagulants are medicines that help prevent blood clots and AF is the most common type of problem with the rate or rhythm of the heartbeat).
• The practice had identified 23 patients in need of end of life care on its register, 16 of these patients (70%) had a care plan.

Updated 28 September 2016

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.
• On site services included ultrasound, phlebotomy, ECGs, physiotherapy and minor surgery.
• Patients aged 40–74 had access to appropriate health assessments and checks that were followed up where abnormalities or risk factors were identified.

Updated 28 September 2016

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

• 78% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to CCG average of 87% and the national average of 84%
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record in the preceding 12 months was 92% which was comparable to CCG average of 84% and the national average of 88%.
• 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.
• On site services included psychology and substance misuse clinics.

Updated 28 September 2016

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 and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability and had identified 68 on its register. 45 of these patients (66%) had received an annual health check. This percentage was derived from year to date performance with a further eight months to go and showed the practice performance was on track.
• 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.
• The practice had a wide range of services available on site.