St Johns Way Medical Centre

Updated 2 March 2017

St Johns Way Medical Centre is located in a purpose built building in a residential area with good transport links and pay and display parking. The practice is a part of Islington Clinical Commissioning Group.

There are 12,993 patients registered at the practice, 42% of whom are aged between 18 and 39 and 51% are of British origin. The practice population is in the fifth deprivation quintile.

The practice has three female and two male GP partners and four salaried GPs carrying out a total of 51 sessions a week. The practice has two practice nurses and a nurse prescriber completing a total of 14 sessions a week, there is a trainee practice nurse and a health care assistant. The practice has a practice manager, a development manager and 11 reception/administration staff members.

The practice is a training practice for GPs and nurses.

The practice operates under a General Medical Services (GMS) contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The practice is open Monday to Friday between 8:00am and 6:30pm, the practice had extended hours evening clinics twice a week. Phone lines are open from 8:00am. Appointment times are as follows:

• Monday 8:30am to 11:40am and 2:00pm to 7:30pm

• Tuesday 8:30am to 11:40am and 2:00pm to 7:30pm

• Wednesday 8:30am to 11:40am and 2:00pm to 6:15pm

• Thursday 8:30am to 11:40am closed rom 1:00pm

• Friday 8:30am to 11:40am and 2:00pm to 6:15pm

The locally agreed out of hours provider covers calls made to the practice whilst it is closed.

The practice hosted the HUB on a Sunday between 10:00am and 4:00pm, which provides GP and nurse appointments to patients from local practices.

St Johns Way Medical Centre operates regulated activities from one location and is registered with the Care Quality Commission to provide treatment of disease, disorder or injury, family planning, diagnostic and screen procedures and maternity and midwifery services.

Updated 2 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Johns Way Medical Centre on 6 December 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 been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 100% of patients completing the friends and family test said they would recommend the practice to someone new to the area.
• 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.
• There was a strong focus on continuous learning in the practice and the practice had completed a large number of clinical audits.

The areas where the provider should make improvement are:

• Continue to work towards ensuring that patients are only exception reported from Quality Outcomes Data where this is reasonable and appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 March 2017

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 percentage of patients on the diabetes register who had a record of a foot examination and risk register recorded in the notes in the preceding 12 months was 87% compared with the national average of 88%.

• 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.

• The practice was a part of a ‘one stop shop’ pilot, which provided patients with more than one long term condition one annual review that incorporated all of their conditions.

Updated 2 March 2017

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.

• The practice held a register of at risk children who did not meet the vulnerability threshold.

• 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.

• 81% of women aged 25 to 64 notes recorded a cervical screening test had been performed in the preceding five years compared to the CCG average of 79% 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 2 March 2017

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 held weekly chair exercise sessions for these patients.

Updated 2 March 2017

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.

• Non urgent email consultations were available where a GP would respond within three days.

• Extended hours appointments were available two evenings a week.

• The practice hosted the local HUB which provided GP and nurse appointments on a Sunday.

Updated 2 March 2017

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

• 76% 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 CCG average of 85% and the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive agreed care plan documented in the record in the preceding 12 months was 91% 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.

• A consultant psychiatrist held regular clinics in the practice.

Updated 2 March 2017

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 held a register of potentially vulnerable patients who did not meet the vulnerability threshold.

• 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.