Archived: Palmerston Road Surgery

Updated 5 February 2015

Palmerston Road Surgery is situated in Buckhurst Hill, Essex and is one of 38 GP practices in the West Essex Clinical Commissioning Group (CCG) area. The practice has a General Medical Services (GMS) contract with the NHS.

Facilities at the practice include parking at the front and the rear of the premises and there is a dedicated bay for those who are disabled. The practice is accessible by public transport and Buckhurst Hill underground station is a short walk away.

There are approximately 4500 patients registered at the practice.

There are three full time GPs working there in partnership, two of whom are female and one male. There is one female Nurse practitioner. There is also a full time and a part time Practice manager and three reception and administration staff.

GP sessions run each day in the morning (8.30am to 1pm) and afternoon (2pm to 6.30pm). On Tuesdays surgery hours are extended until 730pm. The Nurse practitioner works full time and has daily sessions.

The practice have opted out of providing out-of-hours services to their own patients so patients contact the emergency 111 service to obtain medical advice outside of normal surgery hours.

Updated 5 February 2015

Letter from the Chief Inspector of General Practice

On 14 October 2014 we carried out an announced inspection of Palmerston Road Surgery, Buckhurst Hill, Essex under our new approach of inspection of primary medical services. We looked at whether the practice was safe, effective, caring, responsive and well-led.

We found that the practice was outstanding overall for providing responsive services and good across all the other areas we looked at.

We also looked at how the practice provided services to different population groups. Overall we found the practice were good. We did find though that in relation to older people, those experiencing poor mental health and mothers and babies the practice was outstanding in being responsive to their needs.

Patients expressed a high level of satisfaction about the way the services were provided.

Our key findings were as follows:

• Practice staff were kind, caring and dedicated to providing high quality care and treatment.
• The appointment system was highly effective and patients across the population groups were very satisfied with it.
• Patients privacy and dignity was maintained.
• Additional support was provided for the elderly, those experiencing poor mental health and mothers and babies.
• There was visible strong leadership in place resulting in effective systems and processes that kept people safe and met the needs of the practice population. Infection control procedures kept patients and staff safe from a health care related infection.
• The practice worked well with other health care providers to achieve effective outcomes for their patients. Information sharing and communication with partner agencies helped support the levels of care and treatment received by patients.

However, there were also areas of practice where the provider should make improvements. 

The provider should:

• Devise a practice risk assessment that reflects the risks at the practice to patients and staff. 
• Ensure fire drills are practised at appropriate intervals throughout the year.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 February 2015

The practice is rated as good for patients with long-term conditions. Regular reviews of patients took place to ensure they were receiving the most appropriate care and treatment. Patients were signposted to external organisations for support and advice. Patients were able to receive lifestyle advice on how to best manage their conditions from either the GPs or Practice nurse. Diabetes clinics were held monthly with input from a dietician. The Practice nurse saw patients with breathing conditions as part of their daily appointment system. There was evidence that the practice worked with other health care providers for patients with complex needs. The practice also worked closely with two other local practices where complex cases were discussed. This was attended by a GP and the Practice nurse and discussions were held to identify methods of improving the care they provided.

Updated 5 February 2015

The practice is rated as good overall for families, children and young people but in relation to being responsive to their needs we found them to be outstanding. There was an effective system in place to safeguard children from abuse through the use of a register identifying vulnerable patients. These were monitored and multi-agency meetings attended to discuss any issues. Staff had been trained to identify the different signs of abuse. Mothers and babies were able to attend a postnatal and antenatal clinic each week and a paediatric walk-in dedicated surgery was available each Tuesday, outside of school hours. The practice followed immunisation guidance for young babies and children. Parents we spoke with were very positive about the services available to them. Young people were able to book appointments without a parent being present, subject to satisfying GPs of their ability to understand the care and treatment suggested.

Updated 5 February 2015

The practice is rated as good overall for older people but in relation to being responsive to their needs we found them to be outstanding. The practice offered personalised care to meet the needs of older people. Those over 75 had a named GP so that continuity of care could be maintained. The practice kept a register of older people who were identified as requiring additional support. Regular multi-disciplinary meetings were held to discuss individual patients and to put in place care plans to reduce the risk of avoidable hospital admissions. Dementia screening took place to identify early, those at risk. The appointment system reflected the needs of the elderly. A dedicated telephone line was available for those elderly patients considered to be most at need. This enabled them to obtain appointments and medical advice quickly. Telephone consultations and home visits were available if necessary and older patients were given priority. Prescriptions could be ordered by phone and delivered to home addresses by a local pharmacy. An effective flu vaccination programme was in place and staff were pro-active in identifying patients who were eligible. Older patients expressed high praise for the service they received at the practice.

Updated 5 February 2015

The practice is rated as good for working age people. The appointments system met the needs of these patients. Daytime appointments could be booked on the same day or the next day. Evening appointments were available for those people who could not attend the surgery during the day such as students or those at work. Patients could order repeat prescriptions online. The practiced promoted healthy living and appointments were available with the Practice nurse for lifestyle advice. This included smoking cessation and alcohol advice designed to prevent ill health in the future.

Updated 5 February 2015

The practice is rated as good overall for people experiencing poor mental health but in relation to being responsive to their needs we found them to be outstanding. An in-house counselling service was available for patients to access. A representative from the MIND organisation, a mental health charity, attended to run a clinic twice weekly where patients could seek support and appropriate advice. Patients received a regular review of their mental health needs and were pro-actively contacted. A screening process was in place to identify those in the early stages of dementia and relevant guidance and support was offered including signposting patients to external organisations.

Updated 5 February 2015

The practice is rated as good for people whose circumstances may make them vulnerable. A register was maintained of patients with learning disabilities and they were invited to attend an annual review or more frequently if considered necessary. A double appointment was made available to them to ensure their needs were covered. Carers of those living in vulnerable circumstances were identified and offered support including signposting them to external agencies.