Portland Medical Centre

Updated 17 August 2017

Portland Medical Centre provides primary medical services in South Norwood to approximately 12300 patients and is one of 58 practices in Croydon Clinical Commissioning Group (CCG). The practice population is in the fourth least deprived decile in England.

The practice population has a higher than CCG and national average representation of income deprived children and older people. The practice population of children is in line with the CCG and higher than the national average and the practice population of working age people is higher than the CCG and national averages; the practice population of older people is lower than the local and national averages. Of patients registered with the practice for whom the ethnicity data was recorded 18% are White British, 16% are Caribbean and 16% are Other White.

The practice operates in purpose built premises. All patient facilities are wheelchair accessible on the ground floor. The practice has access to four doctors’ consultation rooms and two nurse consultation rooms on the ground floor and two doctors’ consultation rooms and one nurse and one healthcare assistant consultation room on the first floor. Patients who are not able to access the first floor are seen on the ground floor.

The clinical team at the surgery is made up of three full-time GPs (one male and two female) and one part-time female GP who are partners, six part-time salaried GPs (three male and three female), two full-time and three part-time female practice nurses and one full-time and one part-time healthcare assistants. The non-clinical practice team consists of a managing partner and fifteen administrative and reception staff members. The practice provides a total of 64 GP sessions per week.

The practice operates under a Personal Medical Services (PMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract). The practice is a training practice for trainee GPs and medical students.

The practice reception and telephone lines are open from 8:00am to 6:30pm Monday to Friday. Appointments are available from 8:00am to 6:30pm Mondays to Wednesdays and from 8:00am to 6:00pm on Thursdays and Fridays. Extended hours surgeries are offered on Mondays and Tuesdays from 6:30pm to 8:00pm, Thursdays from 7:30am to 8:00am and on Saturdays (once every four weeks) from 9:00am to 12:30pm.

The practice has opted out of providing out-of-hours (OOH) services to their own patients between 6:30pm and 8:00am and directs patients to the out-of-hours provider for Croydon CCG.

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

Updated 17 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Portland Medical Centre on 6 December 2016. The overall rating for the practice was good with requires improvement in safe. The full comprehensive report on the Month Year inspection can be found by selecting the ‘all reports’ link for Portland Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced desk-based review carried out on 14 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation 12 (1) and (2) Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014 that we identified in our previous inspection on 6 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• Risks to patients were assessed and well managed.
• Some of the staff had not undertaken essential training appropriate to their role.
• The practice had a comprehensive business continuity plan for major incidents such as power failure or building damage.
• The practice had a clear system to monitor the implementation of medicines and safety alerts.
• Clinical audits demonstrated quality improvement. The practice had undertaken two completed audits since the last inspection where the improvements were identified, implemented and monitored.
• Four staff members had not received a recent annual appraisal; the practice provided us with reasons for the delay in performing appraisals for these staff and had identified dates for their appraisals.
• Only 21% (12 patients) of 58 patients with learning disability had received a health check in the last year; the practice was aware of this and informed us that health checks for all these patients would be completed this year.
• The practice documented discussions from clinical meetings.
• Information about how to complain was available and easy to understand.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Review practice procedures to ensure systems are in place to identify when staff training needed to be updated.
• Review practice procedures to ensure all patients with learning disability receive a regular health check.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 16 January 2017

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.
• The national Quality and Outcomes Framework (QOF) data showed that 68% of patients had well-controlled diabetes, indicated by specific blood test results, compared to the Clinical Commissioning Group (CCG) average of 70% and the national average of 78%. The number of patients who had received an annual review for diabetes was 63%; the practice informed us that this was due to a coding issue.
• The national QOF data showed that 70% of patients with asthma in the register had an annual review, compared to the CCG average of 74% and the national average of 76%.
• Longer appointments and home visits were available for people with complex long term conditions when needed.
• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice provided minor surgical procedures, phlebotomy, spirometry and electrocardiography to improve monitoring of patients with long term conditions which reduced the need for referrals to hospital.

Updated 16 January 2017

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 urgent care and Accident and Emergency (A&E) attendances.
• Immunisation rates were relatively high for all standard childhood immunisations.
• 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 77%, which was below the Clinical Commissioning Group (CCG) average of 81% and the national average of 82%; the practice had a designated administrative staff who monitored cervical screening uptake and results.
• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice prioritised appointments for children under five years.
• The practice had a designated nurse and healthcare assistant who managed the child protection and vulnerable children register; they also had a designated administrative staff who monitored childhood non-attenders.
• The practice patients had access to midwife for antenatal appointments and GPs for post-natal appointments.

Updated 16 January 2017

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 practice GPs provided care for five local care, nursing and residential homes supporting the needs of 125 residents; each of these nursing homes had a named GP who provided weekly ward rounds jointly with elderly care consultants.
• The practice had a system in place where one of the GPs acted as a Floating GP who was available to deal with home visits.
• All patients on the avoiding unplanned admission register had a named GP had a practice nurse allocated who regularly monitored these patients. 

Updated 16 January 2017

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.
• The practice provided extended hours GP appointments which were suitable for working people.
• The practice had a dedicated e-mail for routine patient queries which was regularly monitored.

Updated 16 January 2017

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

• The number of patients with dementia who had received annual reviews was 76% which was below the Clinical Commissioning Group (CCG) average of 83% and national average of 84%; the practice did not have a clear system for recalling these patients.
• 96% of 178 patients with severe mental health conditions had a comprehensive agreed care plan in the last 12 months which was above the CCG average 86% and national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• The practice patients had access to in-house monthly drug rehabilitation clinics.

Updated 16 January 2017

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, carers, travellers and those with a learning disability.
• The practice offered longer appointments and extended annual reviews for patients with a learning disability; Only 34% (20 patients) of 58 patients with learning disability had received a health check in the last year; the practice informed us that this was due to a practice nurse who monitored these patients was away on a three month sabbatical in the last year.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.
• All vulnerable patients are included in the avoiding unplanned admission register and had a named GP and a clinical co-ordinator (practice nurse) allocated who regularly monitored these patients.