Background to this inspection
Updated
22 November 2016
The practice is located within the Sir Ludwig Guttmann Health and Wellbeing Centre, which was purpose built for the 2012 Olympic games as the Olympic Health Centre. The building was converted in 2013 to provide GP services, Community Health and Wellbeing services and a Pharmacy. The practice is situated in a rapidly developing residential area, close to Westfield and Stratford International Station. Car parking is available in a large multi storey car park nearby.
Liberty Bridge Road Practice is a part of the Hurley Group of GP practices (The Hurley Group is an NHS GP Partnership that runs a number of practices and Urgent Care Centres in London) and is one of a number of GPs located within the Newham Clinical Commissioning Group (CCG). It has a practice list of around 8,000 which is expected to increase due to numerous large new housing developments being built in the area.
The practice staff includes two lead GPs, known by the practice as Local Medical Directors (LMD) (one male and one female), four salaried GPs (male and female) one Physicians Associate (female) , two practice nurses (female), a Senior Practice Operations Manager, a Building Services Manager, a Health Care Assistant and ten reception/administrative staff.
One LMD works eight sessions whilst the other works four sessions .Two of the salaried GPs work six sessions while the other two work one session per week The practice nurse’s work 30 and 24 hours respectively. The Senior Practice Operations Manager and Building Services Manager work full time. The practice is open from 8am and 8pm Monday to Friday and 8am to 2pm Saturdays and Sundays and Bank Holidays. Appointments are from 8am to 8pm daily apart from Tuesdays and Thursdays when appointments start at 7am. Outside of these hours, cover is provided by the Newham Co-op out of hours GP service which operates from 8pm midnight, seven days a week and the NHS 111 service.
The practice’s patient population has an above average number of working age adults aged from 20 to 34 years (66%). The 2011 census shows that the largest ethnic group is white British (27%) and 58% of practices patient group have English as their first language In terms of deprivation Newham is the third most deprived decile.
Updated
22 November 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Liberty Bridge Road Practice on 8 June 2016. Overall the practice is rated as Good.
Our key findings across all the areas we inspected were as follows:
- There was a comprehensive reporting system for reporting and recording significant events, incidents and safety alerts.
- 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.
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Information about services and how to complain was available and easy to understand. Improvements were made to the telephone system and enhanced reception staff training undertaken as result of complaints and concerns.
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The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example they are part of”Clinical communities” of 15 practices in the Hurley Group. Clinical Communities is a networking service that links health professionals by therapy area, it allowed the practice to seek advice when needed, recognise trends across their locality and work together to solve problems.
- The practice is aware of their local population and has opening hours to suit them.
- The provider was aware of and complied with the requirements of the duty of candour.
The areas where the provider should make improvement are:
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The provider should take steps to improve access to the service by reviewing the availability and length of appointments and improving patient satisfaction with telephone access.
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Involve patients in making decisions about their care
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Implement effective arrangements for prescription pads security.
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The practice must insure that it has effective governance including assurance and auditing systems and processes and maintain accurate, complete and detailed records such as fire risk assessment and infection control audits and any remedial actions highlighted and actioned.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
22 November 2016
The practice is rated as good for the care of people with long-term conditions.
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Data showed patient outcomes for diabetes management were low compared to the national average.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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There were alerts for long term conditions on patient records. The practice had a weekly diabetes clinic run by a specialist from Newham General Hospital.
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Longer appointments and home visits were available when needed.
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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.
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The practice had online appointment booking and prescription requests.
Families, children and young people
Updated
22 November 2016
The practice is rated as good for the care of families, children and young people.
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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.
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Patients told us children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
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78% of women aged 25-64 had received a cervical screening test which was comparable to the CCG and national averages of 81% and 82%.
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Appointments were available outside of school hours including weekends and the premises were suitable for children and babies. Children and babies were prioritised for same day appointments.
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We saw positive examples of joint working with midwives and health visitors.
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The practice ran a baby clinic twice a month. During this baby clinic, a GP conducted postnatal checks and 6-8 week baby checks, a nurse administered childhood immunisations on a walk in basis and a health visitor conducted developmental checks and gave feeding and nutrition and health and safety advice.
The practice actively called mothers for their postnatal checks and their babies’ first immunisations and a robust maternity protocol was available to all staff detailing the care offered to mothers from the booking of their pregnancy to their postnatal care
Updated
22 November 2016
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
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The practice participated in the Avoiding Unplanned Admissions Directed Enhanced Service (AUA DES). This enhanced service allows the practice to identify the top 2% of patients who are most likely to be admitted to hospital and to actively work on avoiding unnecessary admissions.
The practice proactively invited older patients for vaccines such as Influenza, Pneumonia and Shingles.
Working age people (including those recently retired and students)
Updated
22 November 2016
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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.
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The practice was proactive in offering online services as well as a full range of health promotion and screening reflects the needs for this age group.
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Same day appointments were available.
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The practice was open from 8am to 8pm Monday to Friday and 8am to 2pm at weekends to accommodate working people.
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Telephone consultations were available.
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Online appointment booking and prescription requests were available.
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The practice also offer the Hurley online consultations whereby patients can upload their symptoms onto a web template which is sent to the practice to be reviewed and acted upon by a doctor within 24 hours.
People experiencing poor mental health (including people with dementia)
Updated
22 November 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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82% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015). This was comparable to the CCG average of 84% and the national average of 88%. The practice holds a mental health clinic once a month this is run in conjunction with the Primary care liaison team.
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The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
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The practice carried out advance care planning for patients with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
People whose circumstances may make them vulnerable
Updated
22 November 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including those with a learning disability. There was also an alert on the patient records where a patient was identified as vulnerable.
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The practice offered longer appointments for patients with a learning disability.
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The practice regularly worked with other health care professionals in the case management of vulnerable patients.
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The Practice ran a legal clinic in conjunction with an external partner to offer patients free legal advice and welfare advice including benefits, housing and debt problems and at the time of the inspection had helped 35 clients with 60 different legal problems
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The practice worked with a local church to offer patients experiencing difficult financial circumstances access to a food bank.
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.