Tudor Way Surgery

Updated 20 October 2016

Tudor Way is a medium sized practice based in Bromley. The practice list size is approximately 7289. The practice population was very diverse with patients from a range of social and economic backgrounds. Life expectancy for males in the practice is 82 years and for females 87 years. Both of these are in line with the CCG and national averages for life expectancy. The practice has a higher than average number of females aged 0-14 and 35-49 years and males 0-9 and 35-44 years.

The practice has one branch site. The main site Tudor Way surgery (in Orpington) has four consulting rooms, two patient waiting rooms and two administration offices. The branch site, Bromley Park surgery (in Bickley) has two consulting rooms, large patient waiting room and reception area. Bromley Park surgery is fully accessible with step-free access, lifts and disabled toilet.

There are four GP partners who work across the two sites. There are two male GP partners and two female GP partners. One of the male partners works eight sessions a week and the other works five sessions a week. Both female GPs work eight sessions a week. Other staff include three female practice nurses, one female healthcare assistant, seven administration and secretarial staff and a practice manager.

Both sites are open from 8.00am to 6.30pm Monday to Fridays and offer extended opening on Monday and Thursdays from 6.30pm to 8.00pm. Appointments are available between 8.30am to 11.30am and 3.00pm to 5.30pm Monday to Friday at both sites. Extended hours appointments are available between 6.30pm to 7.45pm.

When the practice is closed patients are directed (through a recorded message on the practice answerphone) to contact the local out of hour’s provider. This information is made available to patients via their website and is also in the patient handbook.

The practice is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of treatment of disease, disorder or injury; diagnostic and screening; surgical procedures; maternity and midwifery services at both locations.

Updated 20 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tudor Way surgery on 5 July 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 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they could get an appointment with a named GP, although sometimes there was difficulty getting a pre-bookable appointment. Urgent appointments were always available the same day.
• The practice had good facilities and was 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review processes in place for carrying out infection control audits at both sites ensuring that it is clear what issues relate to which site.

• Review the process for sharing and documenting lessons learnt from complaints and incidents ensuring all relevant staff are made aware.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 20 October 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.

• The practice was an advanced diabetes practice and offered extended appointments for annual reviews (via nursing staff).

• Patients with long-term conditions were added to clinical registers. This allowed for staff to monitor their needs such as medication reviews, annual checks and education.

• The practice had a patient liaison officer who monitored patients on the unplanned admissions to hospital register. Discharge summaries were used to check up on the patient following discharge and report to the GP to assess where necessary if the care plan needed updating.

• Longer appointments and home visits were available when needed.

• 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.

Updated 20 October 2016

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

• Processes were in place to carry out six to eight week new baby checks, post-natal checks and baby immunisations.

• Midwives held weekly clinics alternating between both sites. The practice offered support to parents during pregnancy, access to health visitors.

• Immunisations were offered for students preparing for university.

• There was a wide range of sexual health advice and services provided.

• 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 positive examples of joint working with midwives, health visitors and school nurses.

Updated 20 October 2016

The practice is rated as good for the care of older people.

• Annual clinics to administer vaccinations such as influenza, pneumococcal and shingles are offered to patients. Housebound patients are also visited and included in these programmes. Prior to these clinics patients are targeted and contacted by letter, text and telephone calls.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. They provide an additional list to district nurses to visit housebound patients for immunisations, health assessments and review on-going conditions.

Updated 20 October 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. Extended hours were offered two days a week to enable evening appointments.

• Telephone consultations were available

• 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.

• Electronic prescribing was in place to allow patients to choose their pharmacy for collection of medication.

• The practice were part of a local GP alliance which meant their patients could access GP appointments during the evening and weekends through the alliance.

Updated 20 October 2016

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the past 12 months, which is comparable to the national average.

• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in their record, in the preceding 12 months

• 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.

Updated 20 October 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.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• All staff repeated safeguarding training annually.

• 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.