Background to this inspection
Updated
11 February 2016
Dr Christopher Bark provides GP primary care services to approximately 2890 people living in Soho in Westminster and Camden. The practice is staffed by three GPs the owner and two salaried GPs. The GP staff comprises two male and one female doctors who work a combination of full and part time hours. Other staff included a nurse, a counsellor and two administrative staff. The practice holds a General Medical Services (GMS) contract and was commissioned by NHSE London. The practice is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, treatment of disease, disorder and injury and maternity and midwifery services.
The practice is open from 9am to 6pm Mondays to Friday. They do not currently offer any extended hours. The telephones were staffed throughout working hours. Between the hours of 8am to 9am and 6pm to 6.30pm the telephone were answered by the ‘out of hours’ service who contacted the practice GP if patients needed to see a GP. Appointment slots were available throughout the opening hours. The out of hours services are provided by an alternative provider. The details of the ‘out of hours’ service are communicated in a recorded message accessed by calling the practice when closed and details can also be found on the practice website. Patients can book appointments and order repeat prescriptions online.
The practice provided a wide range of services for patients with diabetes, chronic obstructive pulmonary disease (COPD), contraception and child health care. The practice also provided health promotion services including a flu vaccination programme and cervical screening.
Updated
11 February 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection of Dr Christopher Bark Soho Square Surgery on 26 November 2015. 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 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 provider was aware of and complied with the requirements of the Duty of Candour.
The areas where the provider should make improvement are:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
11 February 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 had scored 81.4% on the recent QOF report for diabetes which was above the CCG average.
- 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.
Families, children and young people
Updated
11 February 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.
- 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. Monthly meetings were held, however health visitors were based in the same building as the practice which allowed them to discuss any concerns they had immediately.
Updated
11 February 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. Patients over 75 years had a named GP to co-ordinate their care. One GP specifically focused on older people care and carried out home visits when needed.
- The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs
- The practice participated in the avoiding unplanned admissions Direct Enhanced Service (DES). Data confirmed all unplanned care areas (A&E, Non-elective admissions, Walk in Centre, Urgent Care Centre), had decreased in 2015 compared to 2014.
Working age people (including those recently retired and students)
Updated
11 February 2016
The practice is rated as good for the care of working age people (including those recently retired and students).
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The practice offered on-line services which included appointment management, email consultations, and repeat prescriptions.
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The practice allowed
out of area registrations for people who worked in the area.
People experiencing poor mental health (including people with dementia)
Updated
11 February 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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100% of patients diagnosed with mental health had been reviewed in the last year. The practice employed a part time counsellor whose role included supporting patients with mental illness. We saw they would refer patients to Improving Access to Psychological Therapies (IAPT) or support patients themselves. Reception staff we spoke with were aware of signs to recognise for patients in crisis and to have them urgently assessed by a GP if presented.
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76.9% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is worse than the national average.
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The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
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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.
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Staff had a good understanding of how to support patients with mental health needs and dementia as all staff they had received awareness training for both.
People whose circumstances may make them vulnerable
Updated
11 February 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
- The GPs told us that patients whose circumstances may make them vulnerable such as the homeless, those under safeguarding or people with learning disabilities were offered regular health checks and follow-up.
- They offered longer appointments for patients with a learning disability.
- 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.