The Group Practice at River Place

Updated 8 April 2016

The Group Practice at River Place is located in the London Borough of Islington. The practice is part of the NHS Islington Clinical Commissioning Group (CCG) which is made up of 38 practices.it currently holds a GMS contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract) and provides NHS services to 9561 patients.

The practice serves a diverse population with many patients attending where English is not their first language. Ten percent of the patient population is over the age of 65 and 25% is under the age of 18. The practice is situated within a purpose built centre and shares the building with the Whittington Community Health teams. Consulting rooms are available on the ground level with administration rooms on the first floor. The practice staff comprised of four GP partners (2 male and 2 Female), four female salaried GPs, and two GP registrars (male and female), There are a total of 37 GP sessions per week. The practice also has three nurses (2 female and 1 male) and one male healthcare assistant. Administration staff comprises of a practice manager, assistant practice manager, administrators and reception staff.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8.30am to 12pm every morning and 3.30pm to 6.30 on a Monday, Tuesday and Thursday. The practice is closed for appointments on a Wednesday afternoon, although patients can book appointments and collect prescriptions. The practice is open for emergency appointments only on a Friday afternoon between 3.30pm and 6.30pm Extended surgery hours are offered on a Tuesday and Thursday between 6.30pm and 7pm. In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments are also available for people that needed them. The practice did not provide out of hours treatment but referred patients to the local out of hour’s provider.

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

Updated 8 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Group Practice at River Place on 15 February 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. However no formal policy had been written.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
• Patients said they found it easy to make an appointment with a named 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.
• The practice had an active patient participation group which met on a regular basis.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Ensure policies are written formalising the significant events process.

• Endure staff induction procedures are formalised.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 8 April 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.

• Performance for diabetes related indicators was above the CCG and national average. The practice achieved 100% for all indicators. This was compared to the CCG average of 87.8% and the national average of 89.2%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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 8 April 2016

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.

• 75.4% of patients registered with asthma had received a review in the last 12 months. This was comparable to the national average of 75.5%.

• 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 79%, which was comparable to the national average of 81%.

• 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 8 April 2016

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.

Updated 8 April 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.

• 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.

Updated 8 April 2016

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

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  Performance for mental health related indicators was above the CCG and national average. The practice achieved 100% for all indicators. This was compared to the CCG average of 92.5% and the national average of 92.8%.

• 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.

• 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 8 April 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 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.