The Forest Practice

Updated 18 July 2019

The Forest Practice is situated within NHS Newham Clinical Commissioning Group (CCG) area at Lord Lister Heath Centre, 121 Woodgrange Road, Forest Gate, London E7 0EP which we visited as part of our inspection. The practice is one of three GP practices based within Lord Lister Health Centre. It is situated adjacent to a train station and is well served by local bus routes. Parking is available on the surrounding roads.

The practice patient list size is approximately 7023. The practices' opening hours are 8am to 6.30pm Monday to Friday and GP appointments are available Monday to Friday from 8:30am to 6:00pm. Outside of these hours’ services are available through the 111 which is Newham CCG’s chosen out of hours provider. In addition to pre-bookable appointments that can be booked up to four weeks in advance, urgent appointments are also available for people that need them.

The clinical staff team at The Forest Practice includes two GP partners (one male and one female) collectively working six clinical sessions and four management sessions per week, one female salaried GP working six sessions per week, two long-term locum GPs (one female and one male) collectively working eight sessions per week, five Advanced Nurse Practitioners (four female and one male) collectively working 45 sessions per week, a female Practice nurse working one session per week, a Physicians Associate working nine sessions per week, a healthcare assistant working nine sessions per week and a trainee healthcare assistant working four sessions per week. Non-clinical staff include a General Manager working 37.5 hours per week, an Assistant Manager working 37.5 hours per week, a Duty Manager working 18.75 hours per week, an Administration Manager working 30 hours per week, and a team of reception and administrative staff working a mixture of full and part time hours.

The Information published by Public Health England rates the level of deprivation within the practice population group as three on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The local ethnicity demographic is approximately White 33%, Mixed race 5%, Asian 36%, Black 23%, Other race 3%. The CCG area population has a lower proportion of people aged 65 years or over at 11% compared to 17% nationally.

Updated 18 July 2019

We carried out an announced comprehensive inspection at The Forest Practice 24 June 2019 to follow up on breaches of regulations. CQC inspected the service on 1 May 2018 and asked the provider to make improvements regarding breach of Regulation 17 (Good governance) and Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We checked these areas as part of this comprehensive inspection and found all of the previous concerns had been resolved, but some new concerns under Regulation 17 (Good governance) Health and Social Care Act 2008 were identified.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Systems to assess, monitor and manage risks to patient safety were generally effective.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The practice had a clear vision and positive working culture, some systems had weaknesses that staff immediately remedied, including safety alerts and elements of recruitment or induction for some staff.

Whilst we found no breaches of regulations, the provider should:

• Review and improve systems to ensure care and treatment is provided in a safe way to patients, including staff’s early recognition of signs and symptoms of sepsis.
• Review the recruitment and induction process, such as to ensure locums clinicians induction, working agreements, and occupational health considerations are embedded and formalised.
• Review and improve arrangements systems to ensure management staff and staff at all levels receive appropriate dementia awareness training.
• Review and improve systems for safety alerts.
• Review and evaluate systems to ensure patients see the most appropriate clinician without delay.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 18 July 2019

Updated 18 July 2019

Updated 18 July 2019

Updated 18 July 2019

Updated 18 July 2019

Updated 18 July 2019