First Care Practice

Updated 8 February 2018

First Care Practice provides primary medical services in Hounslow to over 10,000 patients through a general medical services (GMS) contract. It falls within the Hounslow Clinical Commissioning Group (CCG) area.

The practice operates from the ground floor of a purpose built building which is fully accessible to patients using a wheelchair.

The practice clinical team consists of the lead GP and seven salaried and 'regular locum' GPs, a nurse practitioner and seven practice nurses, three healthcare assistants and a phlebotomist. The practice also employs practice managers, administrative staff and receptionists. The practice offers around 34 GP sessions and 25 nurse sessions per week. Patients have the choice of a male or female GP.

The practice is open between 8am and 8pm, seven days a week (including public holidays) with both GP and nurse appointments available throughout the week and at the weekend. The practice provides patients with information about how to access primary care or other health services out of hours if they need urgent advice or treatment.

The practice is registered with the Care Quality Commission to provide the regulated activities of maternity and midwifery service; treatment of disease; disorder or injury; family planning; diagnostic and screening procedures and surgical procedures.

Updated 8 February 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at First Care Practice on 11 October 2016. The overall rating for the practice was requires improvement. We also rated the practice as requires improvement for providing caring and responsive services and issued a requirement notice in relation to a breach of regulation 17. This was because the practice could not demonstrate it had sufficient staff capacity to meet the needs of patients and provide an accessible service.

We also noted that the practice:

• scored consistently below the local and national averages on the 2016 national GP patient survey
• had identified fewer than 1% of its patients as carers.

The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for First Care Practice on our website at www.cqc.org.uk.

This inspection was a focused inspection carried out on 11 December 2017 to confirm that the practice had made improvements since our last inspection and was now meeting legal requirements.

We also followed up concerns received by the Care Quality Commission about the quality of care and leadership at the practice.

Following this inspection, we have rated the practice as good overall. We have rated the practice as good for providing caring and responsive services. We did not find evidence to substantiate the concerns which had been reported to us and the practice's ratings for providing safe, effective and well-led care remain as good.

Our key findings were as follows:

• Since our previous inspection, the practice had increased its clinical capacity and the number of GP and nursing sessions it provided each week. 
• The practice now used regular salaried or locum clinicians to facilitate continuity of care for patients with complex or longer term conditions. 
• The practice promoted telephone consultations where appropriate and online appointment booking to better manage demand.
• The practice's results on the national GP patient survey remained below average in 2017. However, the practice had noted the response rate to this survey was low and had carried out its own survey of patients which showed improving satisfaction levels.
• The practice had increased the number of patients it had identified as carers to 91. The practice offered carers additional support and flexibility in making appointments.
• The practice provided a responsive service. It had a young population and had identified health promotion and lifestyle advice as a key priority for this population group.
• The practice was looking at innovative ways to support and engage patients to manage their own health where appropriate.
• The practice provided an accessible service. The practice was open seven days a week and over public holidays. Emergency and same day appointments were available for patients who required more urgent access.

The areas where the practice should make improvement are:

• The practice should review and, if appropriate, work to reduce its exception reporting rates for cervical screening which were relatively high in 2016/17.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 8 February 2018

Updated 8 February 2018

Updated 8 February 2018

Updated 8 February 2018

Updated 8 February 2018

Updated 8 February 2018