Richmond Road Medical Centre

Updated 19 July 2016

Richmond Road Medical centre is located in South West Hackney and holds a Personal Medical Services (PMS) contract and is commissioned by NHSE London. The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of treatment of disease, disorder or injury, diagnostic and screening procedures and maternity and midwifery services.

The practice is staffed by two full-time GP partners, one male and one female, who provide eight sessions a week and one salaried male GP who provides five sessions a week. The practice also employs one interim part-time practice manager who works 10 hours a week, one full time practice nurse who works 37.5 hours, one sessional pharmacist, one healthcare assistant (HCA) who works 24 hours a week and four reception and administrative staff. The practice is an established teaching practice for medical students from three different medical colleges.

The lead GP is a member of the clinical executive committee of the CCG and also chairs the local Individual Funding Request (IFR) team. Additionally, he is the Vice Chair for KLEAR Consortia and a member of the Planned Care Board of the CCG. The salaried GP works for the GP confederation that supports failing practices.

The practice is open between 8.00am and 6.30 pm on Monday to Friday. Appointment times are from 9.00am. Extended hours surgeries are offered on Tuesday from 6.30pm to 8.00pm and Wednesday from 6.30pm to 7.30pm. The answerphone redirects patients to an out of hours provider at the following times: 6.30pm to 8.00am on Monday, Thursday and Friday, 8.00pm to 8.00am on Tuesday and 7.30pm to 8.00am on Wednesday. Telephone appointment slots are offered from 11.00am to 12.30pm daily.

The practice has a list size of 3700 patients and provides a wide range of services including immunisations, vaccinations, screening, mental health management, antenatal and postnatal care, family planning and exercise classes.

The practice is located in an area where the majority of the population are working age people between 25 – 64 years of age.

Updated 19 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Richmond Road Medical Centre on 28 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• The practice also achieved the highest performance targets for all long term conditions in the CCG.
• Patients said they were treated with compassion, dignity and respect.
• 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.
• 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 one area of outstanding practice:

The practice was performing highly compared to practices nationally and locally. Despite the high prevalence of diabetes in the borough, the practice achieved the highest performance for diabetes related indicators in the Clinical Commissioning Group (CCG). The practice achieved 85% and 100%, the CCG and national average ranges between 75% and 93%. The practice also achieved the highest performance targets for all long term conditions in the CCG with performance related indicators ranging between 90% and 100%, higher than the CCG and national average of 70% and 96%.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 19 July 2016

The practice is rated as outstanding 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.

• Despite the high prevalence of diabetes in the borough, the practice achieved the highest performance for diabetes related indicators in the CCG which was between 85% and 100%, higher than the CCG and national average ranging between 75% and 93%.

• The practice also achieved the highest performance targets for all long term conditions in the CCG and the performance related indicators ranged between 90% and 100%, higher than the national average of 70% and 96%.

• The named GP worked with relevant health and care professionals to deliver a robust multidisciplinary package of care.

• The practice had an effective system in place which focused on health promotion and routine screening of patients at risk of diabetes at new registration checks.

• The practice ensured retinal screening appointments were in place and any patients that did not attend (DNA) were followed up, rescheduled accordingly and monitored through their DNA audits.

• They took into account patients’ religious needs such as fasting and ensured they were offered appointments once their fast times ended.

• The practice had a system in place that ensured all patients with long term conditions received a structured annual health review which included psychological input from the mental health team.

• Annual reviews were tailored to reduce the need for patients to visit the surgery repeatedly.

• They made use of prompt sheets prior to patient reviews that enabled them to formulate their ideas and concerns and all these patients had personalised care plans.

Updated 19 July 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 children with long term conditions were followed up within 48 hours or sooner if required.

• Immunisation rates were relatively high for all standard childhood immunisations. For example, data published between March 2014 – March 2015 showed immunisation rates for babies to two year olds were 100% and the under-fives ranged from 88% to 97%.

• The practice had undertaken 90% of annual reviews for patients diagnosed with asthma compared to a national average of 70%.

• The practice’s uptake for the cervical screening programme was 87% compared to a national average of 80%.

• 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.

• The practice offered 16th birthday health checks.

• Same day appointments and appointments outside of school hours were available. The premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors.

Updated 19 July 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 and worked effectively with members of the multidisciplinary team (MDT).

• The practice was responsive to the needs of older people, and offered home visits for housebound patients for chronic disease reviews, phlebotomy and immunisations.

• The practice offered urgent appointments for those with enhanced needs.

• The practice worked in partnership with external organisations to offer in house exercise classes every week for over 50’s in order to promote their mental and physical wellbeing.

  Nationally reported data showed that the practice achieved the highest target across all conditions commonly found in older people. For example, data published in 2014/2015 showed the percentage of patients with atrial fibrillation who were being treated with anticoagulation therapy was 100%, higher than the national average of 95%.

Updated 19 July 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.

• They offered extended hours appointments twice a week on Tuesday between 6.30pm and 8.00pm and Wednesday between 6.30pm and 7.30pm.and provided daily telephone consultations.

• The practice was proactive in offering online services such as electronic and fax prescribing as well as a full range of health promotion and screening that reflects the needs for this age group.

• They offered health checks and annual reviews to this age group as well as health promotion services including HIV screening.

Updated 19 July 2016

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

• Data published from April 2014 to March 2015 showed 100

• The practice carried out advance care planning for patients with dementia.

• The practice worked closely with Alzheimer Society advisers who were attached to the practice.

• 93% of patients with mental health conditions had a comprehensive care plan in place compared to the national average of 88%.

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

• 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 19 July 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 and those with a learning disability.

• The practice offered same day and longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and individual care plans were in place.

• 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 and had received domestic violence training.

• The practice held a safeguarding register for vulnerable 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.

• The practice offered homeless new patient registrations for homeless patients. Once the practice completed their new patient health check, they referred them to a designated homeless practice.