Archived: The Redbridge Surgery

Updated 24 March 2017

The Redbridge Surgery provides primary medical services in Redbridge, Essex to approximately 3600 patients and is a member of NHS Redbridge Clinical Commissioning Group (CCG).

The practice population is in the third least deprived decile in England. Twelve percent of children live in income deprived households compared to a local average of 19% and a national average of 20%. The practice had surveyed the ethnicity of the practice population and had determined that 12% of patients described themselves as white, 80% Asian, less than 1% black and 7% as having mixed or other ethnicity.

The practice operates from a converted residential property with patient facilities on the ground floor. The ground floor is wheelchair accessible. There are offices for administrative and management staff on the ground and first floors. Both the ground and first floors are accessed via stairs.

The practice operates under a General Medical Services (GMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract). The enhanced services it provides are: meningitis immunisation; alcohol brief intervention; childhood vaccination and immunisation scheme; extended hours access; facilitating timely diagnosis and support for people with dementia; influenza and pneumococcal immunisations; learning disabilities; patient participation; rotavirus and shingles immunisation; and unplanned admissions.

The practice team at the surgery is made up of one full-time female GP principal along with two part-time locum GPs (one female and one male). The doctors provide, between them, 14 clinical sessions per week. The nursing team consists of one part-time female practice nurse.

There are six administrative, reception and clerical staff including a full-time practice manager.

The practice is open:

9.00am to 6.30pm Monday, Tuesday and Friday.

9.00am to 8.30pm Wednesday.

9.00am to 1.30pm Thursday.

GP appointments are available

9.30am to 12.00pm, and 4.00pm to 6.00pm Monday to Wednesday and Friday

9.30am to 12.00pm Thursday.

Nurse appointments are available

3.30pm to 6.30pm Monday

9.30am to 1.00pm or 6.00pm to 8.00pm Wednesday

2.00pm to 6.00pm Friday

Extended surgery hours are offered

6.30pm until 8.30pm on Wednesday evenings.

The practice is part of a GP hub, enabling patients to get appointments up to 10.00pm on weekday evenings, with weekend appointments available between 8.00am to 10.00pm on both days. The practice does not open on a weekend. The practice has opted out of providing out of hours (OOH) services to their own patients when it is closed and directs patients to the OOH provider for NHS Redbridge CCG.

The Redbridge Surgery is currently registered as a partnership with the Care Quality Commission. However, one of the two partners (Dr Subberwal) left the practice on 1 October 2015. Accordingly the practice is applying to de-register as a partnership and then to register as a sole principal led by Dr Qazi. It provides the regulated activities of treatment of disease, disorder or injury; diagnostic and screening procedures; and family planning.

This practice has not previously been inspected by CQC.

Updated 24 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Redbridge Surgery on 23 November 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Not all staff had received all pre-employment checks and mandatory training.
• Results of the national GP patient survey showed that the practice was performing below local and national averages in a number of areas. The practice was aware of this and had taken action to improve.
• Some patients said they were not happy with the practice’ opening hours or with telephone access. The practice had taken action to improve access.
• Less than 1% of patients had been identified as carers.
• The practice’ uptake of its cervical screening programme was below both local and national averages.
• Most patients said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• 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.
• 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:

• Consider ways to improve uptake of its cervical screening programme for the benefit of female patients.
• Continue to monitor and address the issues highlighted in the national GP patient survey in order to improve patient satisfaction, including: the practice’ opening hours; overall satisfaction; and phone access.

• Review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

• Ensure that all staff recruitment includes undertaking all relevant pre-employment checks.

• Continue to ensure that staff receive appropriate training and updates, including: basic life support, infection prevention and control, fire safety, information governance; and health and safety.

• Display its mission statement in the reception area so that staff and patients are aware of the practice’ overarching purpose.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 24 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 with diabetes, with well-controlled blood sugar levels in the preceding 12 months was comparable to the CCG and national averages.

• 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 24 March 2017

The practice is rated as good for the care of families, children and young people.

• 74% of women aged 25-64 notes recorded that a cervical screening test had been performed in the preceding 5 years which was below the CCG (79%) and national (82%) averages.

• 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 and health visitors.

Updated 24 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.

• When families suffered a bereavement the practice wrote and phoned to offer condolences and to signpost them to local support groups.

Updated 24 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 reflected the needs for this age group.

• The practice offered extended hours clinics on Wednesday evenings for the benefit of patients who were unable to attend during working hours.

Updated 24 March 2017

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

• 95% of patients with schizophrenia, bipolar affective disorder and other psychoses had had their alcohol consumption recorded in the preceding 12 months, which was better than the national average.

• 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 24 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 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.