Ridgmount Practice

Updated 6 March 2017

The Ridgmount Practice operates from 8 Ridgmount Street, London WC1E 7AA. It moved to the newly built / refurbished premises in April 2016. It had formerly been known as the Gower Place Practice. The premises are located close to Goodge Street, Euston Square and Tottenham Court Road underground stations and there are good bus services nearby.

The practice provides NHS services through a General Medical Services (GMS) contract to approximately 16,000 patients. Many of the patients are university students and there are seasonal variations according to the academic year, with several thousand patients leaving or joining the patient list. A significant number of the students are foreign nationals, with Chinese patients making up the largest group among them. The patient profile shows that the number of patients in the age range 17-24 years is significantly higher than average, at 68% of the list; patients aged between 25 and 34 years make up 25% of the patient list, which is higher than average; the number of patients below-16 (0.3%) and over-35 (6%) is significantly below the average. The deprivation score for the practice population is in the fourth “more deprived decile”, indicating a slightly higher than average deprivation level among the patient group.

The practice is part of the NHS Camden Clinical Commissioning Group (CCG) which is made up of 35 general practices. It is registered with the Care Quality Commission to carry out the following regulated activities - Diagnostic and screening procedures; Maternity and midwifery services; Family planning; Treatment of disease, disorder or injury.

The practice’s clinical team is made up of three partner GPs (one female and two male); five female salaried GPs; three nurse practitioners and a practice nurse. The three partners and two of the salaried GPs each work on average eight clinical sessions per week; the other salaried GPs each work an average of four clinical sessions per week. One of the salaried GPs was on long-term leave and cover was being provided by a locum GP. Two of the nurse practitioners work fulltime; the third and the practice nurse are part-time.

The administrative team of nine is comprised of a practice manager and assistant manager, an IT administrative assistant, two secretaries, a reception manager and three receptionists.

The practice opens between 9 am and 5.30 pm, Monday to Friday. The practice is closed at weekends and has opted out of providing an out-of-hours service. Telephone calls are answered by the practice between 9 am and 5.30 pm. Between 8 am and 9 am and between 5.30 pm and 8.30 pm, Monday to Friday, calls are put through to the out of hours provider. Between 6.30 pm and 8 am, calls are routed initially to NHS 111, and may also be passed through to the out-of-hours provider in appropriate circumstances.

Routine appointments are 10-15 minutes long, although patients can book double appointments if they wish to discuss more than one issue or, for example, if an interpreter is needed. Appointments for reviewing long term conditions are 30 minutes long. If they have previously registered for the system, patients can book or cancel appointments and request repeat prescriptions online. The practice also has a 24-hour system for booking appointments by phone, for patients without online access. Patients who have provided their mobile numbers and consent are sent text message reminders of their appointments. Emergency home visits are available for patients who for health reasons are not able to attend the practice.

In addition, the GPs provide a triaged walk-in service each morning between 9.30 am and 10.30 am and each afternoon between 2.30 pm and 3.30 pm. The nurses also operate a walk-in service between 9 am and 11 am each morning and between 2 pm and 4 pm each afternoon.

Evening appointments, at another location in south Camden, can be booked by the practice reception staff at a patient’s request. In addition, a number of Saturday appointments are available under a local scheme operating at three locations across the borough.

There is information given about the out-of-hours provider and the NHS 111 service on the practice website, together with details of a local walk-in clinic, which any patient can attend.

Updated 6 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 1 December 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 told us they had good access to the service and there was continuity of care.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about how to complain was available and easy to understand. Comments and complaints were analysed and improvements were made to the quality of care as a result of complaints and concerns.
• 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 was aware of and complied with the requirements of the duty of candour.

However, there was an area of practice were improvement should be made:

• The practice should continue with efforts to identify patients with caring responsibilities, so that they may offered and have access to appropriate support.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 6 March 2017

The practice is rated as good for the care of people with long-term conditions.

• The practice’s performance relating to diabetes care was above local and national averages.
• The practice maintained a register of 87 patients with diabetes, of whom 90% had received an annual foot check and 70% had received an annual retinal check.
• The percentage of patients with diabetes on the register, in whom the last IFCCHbA1c is 64 mmol/mol or less in the preceding 12 months (01/04/2015 to 31/03/2016) was 80%, compared with the national average of 78%. The percentage of patients with diabetes on the register, whose last measured total cholesterol (measured within the preceding 12 months) is 5 mmol/l or less (01/04/2015 to 31/03/2016) was 85%, compared with the national average of 80%
• Data showed the practice’s performance relating to patients with atrial fibrillation (21 patients), hypertension (166 patients), chronic obstructive pulmonary disease (17 patients) and asthma (267 patients) was comparable with the national average.
• Nine out of ten patients with heart failure had had an annual medicines review.
• Longer appointments and home visits by GPs and nurses were available when needed.

Updated 6 March 2017

The practice is rated as good for the care of families, children and young people.

• For demographic reasons, the practice had low numbers of children on its patient list, but it had appropriate 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.
• There was a correspondingly low number of under-five year olds, with the take up rates for standard childhood immunisations being generally comparable with averages.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The premises were suitable for children and babies, with baby changing facilities.
• Children aged under-5 attending the practice were prioritised to minimize waiting.

Updated 6 March 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 made provision for urgent appointments for those with enhanced needs. Older patients were prioritised at the practice’s walk-in clinics.
• The practice maintained a case management register of 326 patients at high risk of admission to hospital. Data showed there had been 50 unplanned admissions and all had been followed up within three days of notification of discharge.
• There was a complex care / frailty register of 10 patients, all of whom had up to date care plans.
• Records showed that 50 patients, being 76% of those who were prescribed five or more medications, had had a structured annual review since April 2016.
• Data showed that 20 patients identified as being at risk of developing dementia had received a cognition test or memory assessment.

Updated 6 March 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice was proactive in offering online services that reflects the needs for this age group, including online registration for students.
• Walk-in clinics were run by GPs and nurses each weekday morning and afternoon.
• Evening and Saturday appointments were available at nearby practices under local working arrangements.
• Telephone consultations were available and patients could correspond by email over non-urgent healthcare issues.
• The practice’s uptake for the cervical screening programme was comparable with averages.
• Data showed that 237 patients aged over-16 had been offered health checks and 153 (65%) had been carried out; 483 patients (97% of those eligible) had undergone blood pressure checks in the last five years.
• The practice offered a full range of health promotion and screening, including chlamydia, for patients aged under-25, and HIV testing.
• One of the GPs specialised in sports medicine.
• We saw evidence of close and effective liaison with University College London, concerning the healthcare needs of students who make up a large proportion of the patient list.

Updated 6 March 2017

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

• The percentage of patients diagnosed with dementia (six patients) whose care plan has been reviewed in a face-to-face review in the preceding 12 months (01/04/2015 to 31/03/2016) was 100%, compared with the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses (46 patients) who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2015 to 31/03/2016) was 88%, comparable with the national average.
• Data showed that 78% of patients with severe mental health problems who receive annual physical health check in last 12 months.
• Continuity of care for patients experiencing poor mental health was prioritised.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• The practice worked closely with University College London, relating to students’ mental health issues. It had a specific risk protocol and provided patients with an information sheet containing guidance and the contact details of support organisations.

Updated 6 March 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice had few patients from this group on its list. Patients with a learning disability had received an annual follow up and the care plans were up to date.
• The practice offered longer appointments for patients with a learning disability.
• Homeless patients could register with the practice’s address to access healthcare and welfare services.
• A number of patients lived at a hostel, and the practice offered referral to local services, such as self-help groups, alcohol and drug misuse services and domestic violence support.
• 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.