Chigwell Medical Centre

Updated 27 April 2018

Chigwell Medical Centre is located in a two storey converted house within a residential area in Ilford. Attached to the practice is an independent pharmacy. All consulting rooms are on the ground floor.

The practice is part of NHS Redbridge Clinical Commissioning Group (CCG) which consists of 46 GP practices.

The practice provides NHS primary care services to approximately 8,800 patients living in Hainault and Chigwell through a General Medical Services (GPMS) contract. The practice has a higher population of patients aged over 65 than the England average (19.2% compared to 17.1%).

Thirty one percent of the registered practice population were from Black, Asian and Minority Ethnic groups with the remaining 69% being white.

Information published by Public Health England rates the level of deprivation within the practice population group as seventh on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

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

The practice provides a number of enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract) including minor surgery, coil fitting and learning disability health checks. Private travel vaccinations are offered in addition to those available free of charge on the NHS.

The practice has four care homes within the catchement area, with a dedicated GP responsible for each care home. Each GP does a regular ward round once per week.

The practice has two male and two female partners (21 sessions per week) and one salaried GP (4 sessions per week). There are three practice nurses, one health care assistant and 15 reception/administrative staff. There was a full time practice manager who was on long term leave at the time of our inspection. The practice had engaged a self-employed consultant acting as an interim practice manager.

The practice’s opening hours are 8am to 6:30pm Monday to Friday with the exception of Thursday when the practice closes at 1pm. Appointments with doctors and nurses are available throughout the day. The practice has opted out of providing an out-of-hours service. When closed, patients are directed to the local out-of-hours service provider. Information regarding this is given on the practice website and the practice leaflet, together with details of the NHS 111 service.

Appointments can be booked online, some being available the next day. Urgent appointments are also available for patients who need them.

A GP Partner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in

the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Updated 27 April 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 12 April 2016 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced inspection at Chigwell Medical Centre on 7 February 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review the results of the National GP Patient Survey and look at ways to improve performance as regards local and national averages.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 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.

• Performance for diabetes related indicators was similar to the national average. For example, the percentage of patients on the diabetes register with a record of a foot examination and risk classification within the preceding 12 months was 91% compared with the national average of 88%.

• The practice had signed up to a programme called 100 day challenge to improve the care of patients with diabetes.

• 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 3 October 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.

• 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 67%, which was comparable to the CCG average of 76% and the national average of 82%.

• 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 3 October 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.

• The practice had a carer’s pack and carers leaflet as well as a dedicated administration member of staff to support carers.

Updated 3 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.

• 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.

• The practice offered telephone consultations Monday to Friday from 8:00am to 8:30am for patients who were unable to attend the practice during normal opening hours.

Updated 3 October 2016

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

• 97% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 97% compared with the national average of 88%.

• 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 3 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, travellers 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.

• 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.