Archived: Dr Kathleen Ring Also known as The Crescent Surgery

Updated 21 May 2015

The Crescent Surgery provides GP primary medical services to approximately 2372 patients living in the London Borough of Bromley. Demography of people using the service aged 50-74 are above both the England and CCG averages for female patients. Rates for male patients were broadly in line with both England and the CCG averages except for the number of male patients aged 65-69, which was higher than both averages.

The practice facilities include two consulting rooms, induction loop, wheelchair access, step-free access, a disabled WC, type talk and signing service.

Dr Ring is a single handed GP. Other practice staff include a nurse practitioner, healthcare assistant, and a secretary and reception staff. The practice holds a general medical services (GMS) Contract. A GMS contract is a contract between general practices and NHS England for delivering primary care services to local communities.

The practice has opted out of providing out of hours (OOH) services to their patients. If patients required advice or assistance out of hours they were directed to the’111’ service for healthcare advice.

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

The practice opening hours are between 8am to 6.30pm Monday to Fridays. GP appointments are available between 8-11am and 4-6.12pm. The practice offer extended hours on Mondays between 6.30pm to 7.10pm. Although the practice do not have a website they offer online appointments, repeat prescription, test results and access to medical record facilities through a generic website for all NHS patients. Home visits were available for housebound, elderly and frail patients and any other patients who were unable to attend the practice.

The practice provides a range of services including an asthma clinic, child health and development clinic and long–acting reversible contraception.

Updated 21 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr K Ring on 23 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, safe, caring and responsive services. It was also good for providing services for all the population groups.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment with the GP and that 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 May 2015

The practice is rated as good for the care of people with long-term conditions. Longer appointments were offered to patients with long term conditions. The healthcare assistant and nurse provided the baseline monitoring for most patients however the GP saw the diabetic patients for their annual review so that all aspects of their care needs could be co-ordinated. The GP also undertook the annual foot check and the prescribing review for diabetic patients and worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Patients with long-term conditions such as rheumatoid arthritis, heart disease, Parkinson’s disease, kidney disease and dementia were also reviewed annually.

Seasonal flu and pneumococcal vaccinations were offered annually.

Updated 21 May 2015

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. 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Pre-natal and antenatal care was provided to pregnant woman and women who had recently given birth. The practice ran a Children’s clinic which included delivering the immunisation programme.

Updated 21 May 2015

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 and had a range of enhanced services, for example, avoiding unplanned admissions and had met the target of having care plans for 2% of the patient population. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. For example the practice made telephone calls to all older people to offer the seasonal flu vaccination and the GP carried out home visits to all older patients who were unable to attend the practice to receive it.

The practice offered support and signposting advice for services such as making blue badge applications, benefit applications and dial a ride services. The practice had good links with other providers to ensure the needs of older people were met.

Updated 21 May 2015

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 appointment booking and medication requests as well as a full range of health promotion and screening that reflects the needs for this age group. Extended hours were available on Monday evenings.

Updated 21 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). There were 14 patients on the mental health register and 100% had received an annual physical health check, blood pressure check, alcohol status recorded and where relevant a smear test recorded.

The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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 in the community. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 21 May 2015

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 those with a learning disability.

There were six patients on the learning disabilities register and the practice had carried out annual health checks for them all. They also offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.