The Park End Surgery

Updated 29 September 2016

The Park End Surgery operates from 3 Park End, in a courtyard off South Hill Park, London NW3 2SE. The premises are owned by some of the partner GPs and were converted from industrial use. The practice is located near Hampstead Heath overground station and has good transport links.

The practice provides NHS services through a Personal Medical Services (PMS) contract to approximately 6,500 patients. It is part of the NHS Camden Clinical Commissioning Group (CCG) which is made up of 40 general practices. The practice is registered with the Care Quality Commission to carry out the following regulated activities - Maternity and midwifery services; Treatment of disease, disorder or injury; and Diagnostic and screening procedures. The patient profile has a lower than average late teenage and young adult population, with more than average working age and older patients. The practice showed us figures indicating that 8.94% of patients on its list were aged over-75 years, being the highest rate within the CCG area. The practice has a low deprivation score, being in the second “less deprived decile”.

The practice has a clinical team of four partner GPs (two female and two male), and two male salaried GPs. The partner GPs work between three and six clinical sessions per week; the salaried GPs work four sessions. There is a female practice nurse who works seven clinical sessions a week, and two healthcare assistants, working five sessions each. It is a teaching practice, with three registrars (qualified doctors gaining general practice experience) currently placed there. There is a practice manager and an administrative team 11.

The practice’s opening hours are as follows - it does not close at lunch time:

Monday 9:00 am - 8:00 pm

Tuesday 8:00 am - 4:30 pm

Wednesday 9:00 am - 6:30 pm

Thursday 8:00 am - 4:30 pm

Friday 9:00 am - 6:30 pm

Morning and afternoon sessions for routine booked appointments are as follows:

Monday 9.00 am – 10.45 am 2.30 pm – 8.00 pm

Tuesday 8.00 am – 10.45 am 2.00 pm – 4.15 pm

Wednesday 9.00 am – 10.45 am 2.30 pm – 6.00 pm

Thursday 8.00 am – 10.45 am 2.00 pm – 4.15 pm

Friday 9.00 am – 10.45 am 2.30 pm – 6.00 pm

Routine appointments are 15 minutes long and can be booked up to one month in advance. If they have previously registered for the system, patients can also book appointments and request repeat prescriptions online.

In addition, the practice provides quick access appointments between 9.40 am and 12.30 pm, Monday to Friday. These appointments are 10 minutes long and can be booked by phone or in person, 48 hours in advance or on the same day. The quick access service is operated by the GPs on a rota basis and patients may not be able to see the GP of their choice. The GPs also conduct telephone consultations with patients and make home visits.

The practice is closed at weekends, but a number of weekend appointments are available under a local scheme operating at three locations across the borough. The practice has opted out of providing an out-of-hours service. Patients calling the practice when it is closed are connected with the local out-of-hours service provider. There is information given about the out-of-hours provider and the NHS 111 service on the practice website.

Updated 29 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 10 August 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 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 upon.
• The provider was aware of and complied with the requirements of the duty of candour.
• Data showed the practice was performing above local and national averages in several aspects of care.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 29 September 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice held monthly meetings to discuss patients at higher risk of unplanned admission to hospital.
• Longer appointments and home visits were available when needed.
• The practice’s performance relating to diabetes care was above local averages.
• The practice maintained a register of 186 patients with diabetes, of whom 146 (82%) had undergone a foot examination and 177 (91%) had undergone retinal screening.
• The influenza vaccination rate for patients with diabetes was 92%, comparable with local and national averages.
• The practice maintained of register of 55 patients with heart failure, all of whom had had an annual medicines review in the preceding 12 months.
• The practice’s performance relating to asthma, hypertension, and chronic obstructive pulmonary disease was comparable with local and national averages.

Updated 29 September 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 and maintained a register of vulnerable children.
• Take up rates for all standard childhood immunisations were above the local average.
• 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, including monthly MDT meetings.

Updated 29 September 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 provided urgent appointments for those with enhanced needs. It carried out a high number of home visits, reflecting the needs of this patient group.
• The practice maintained a case management register of patients at high risk of admission to hospital. There were 123 patients were currently on the register, 116 of whom (94%) had up to date care plans.
• Fifty-six out of 57 patients on the register discharged from hospital in the last twelve months had been given a follow-up appointment.
• Records showed that 924 patients were prescribed four or more medications, of whom 848 (92%) had had a structured annual review.
• The uptake for bowel cancer screening was above the local average.
• Two hundred and fifty-six patients identified as being at risk of developing dementia had been offered cognition testing.

Updated 29 September 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• 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.
• Early morning and evening appointments were available for those patients who could not attend during normal working hours.
• Telephone consultations were available and patients could email GPs regarding non-urgent matters.
• The practice’s uptake for the cervical screening programme was above the local average.
• Data showed that 2,851 patients (93% of those eligible) had undergone blood pressure checks in the last five years.

Updated 29 September 2016

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

• Seventy-two per cent of the 104 patients experiencing poor mental health had a comprehensive, agreed care plan documented in the record, in the preceding 12 months, comparable with local and national averages.
• Eighty-three per cent of the 35 patients diagnosed with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months, comparable with local and national averages.
• 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.
• Continuity of care for patients experiencing poor mental health was prioritised.
• 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 29 September 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 one homeless person and five patients 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.