Well Street Surgery

Updated 12 April 2016

Well Street Surgery is a practice based in Hackney, London, and serves a diverse population of approximately 13,600 patients. The local population is 60.9% White, 17.6% Black/African/Caribbean/Black British, 8.7% Asian/Asian British, 8.1% as mixed/multiple ethnic groups, and 4.7% as other ethnic groups.

The practice has six GP partners, six salaried GPs (five male and seven female GPs in total), as well as up to two trainee GPs. There are also four practice nurses, a practice manager and deputy practice manager, a pharmacist, health care assistant and a number of administrative and reception staff. The practice is a teaching and a training practice.

The practice is open from 8:30am to 1:00pm every weekday morning and from 2:00pm to 6:30pm every weekday afternoon, except Thursdays. Appointments are available from 9:00am to 12:45pm and from 2:30 to 6:00pm on Mondays, from 8:30am to 12:45pm and 2:30pm to 8:30pm on Tuesdays, from 9:30am to 12:45pm and 2:30pm to 6:00pm on Wednesdays, from 8:30am to 12:45pm on Thursdays, and from 9:30am to 12:45pm and 2:30pm to 6:00pm on Fridays.

When the practice is closed, patients are re-directed to an out-of-hours service.

The practice is registered to provide diagnostic and screening procedures, family planning services, maternity and midwifery services, surgical procedures, and for the treatment of disease, disorder or injury.

Updated 12 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Well Street Surgery on 21 January 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.
• 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.

We saw two areas of outstanding practice:

• Some staff of the practice had been involved in setting up a charity, ‘Helping Hackney Health’, which offered healthy cooking and education courses to patients with learning disabilities, families, people from various communities in the practice area, diabetic patients and people with poor mental health. The practice found that those attending the courses increased their fruit and vegetable consumption over the duration of the course (fruit from 1.52 to 2.53, vegetables from 1.41 to 2.61) and 90% of participants were ‘confident’ at the end of the course in reading food labels compared to 58% at the beginning of the course.

• The practice directly employed a pharmacist, who took a lead in medicines reconciliation and medicines audits, and was able to provide tests, advice and reviews for patients with complex needs or long term conditions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 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.

• The practice worked with specialist nurses to hold on-site clinics for a number of long-term conditions.

• The practice pharmacist provided medicines reviews and testing (such as spirometry) for patients with complex needs and long-term conditions.

• Self-management courses were available at the practice to those with long-term conditions.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 12 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 comparable to local and national averages for all standard childhood immunisations.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice ran a weekly baby clinic with GPs, practice nurses and health visitors present.

• A psychology service was run on site for patients up to the age of 18 years.

• We saw good examples of joint working with midwives, health visitors and school nurses.

• 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.

Updated 12 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.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice offered on-site phlebotomy, improving access to this service for frail and older patients.

Updated 12 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 offered an evening clinic with appointments available with the GPs and practice nurses.

• 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 12 April 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• It 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.

• There were on-site Primary Care Psychology and counselling services available to patients.

• It 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 received training on how to support people with mental health needs and dementia.

Updated 12 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, travellers and those with a learning disability.

• There was a weekly clinic with a Turkish speaking advocate at the practice, and the practice utilised local translation and advocacy services when necessary.

• It offered longer appointments for people who would benefit from these.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told 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.