Archived: Riverside Medical Centre

Updated 25 November 2016

Riverside Medical Centre is part of Lambeth Clinical Commissioning Group (CCG) and serves approximately 10,450 patients. The practice is registered with the CQC for the following regulated activities: Surgical Procedures, Diagnostic and Screening Procedures, Maternity and Midwifery Services, Treatment of Disease, Disorder or Injury and Family Planning.

The practice has a significantly higher proportion of those aged between 20 and 40 years old than the national and CCG average and a substantially lower proportion of those aged over 55. The practice informed us that only 223 of their patients were aged over 65 and 770 under 18. The practice had the highest proportion of employed patients in the CCG and the lowest proportion of patients with a long standing health condition.

The practice is part of The Hurley Clinic Partnership. The partnership is comprised of five partners. There are two male GPs and one female GP working at the practice. There is a female nurse and a female Physician’s Associate. The practice provides 29 clinical sessions and eight Physician’s Associate sessions per week. The practice informed us that two GPs had recently left the practice and that they were intending to recruit for an additional 13 sessions and a part time nurse. In the interim these sessions were covered by locum staff.

The practice is open from 7.30 am on Monday, Wednesday and Thursday and 8 am on Tuesday and Friday. The practice closes at 7 pm on a Monday, 6.30 pm on Tuesday and Friday and 8 pm on Wednesdays and Thursdays. The practice offers booked and emergency appointments five days per week.

Riverside Medical Centre operates from Hobart House St Georges Wharf, London, SW8 2JB which is a purpose built health centre owned by the Hurley Clinic Partnership. The service is based on the first floor of a purpose built health centre. The premises are accessible to those with mobility problems and there is a lift which provides access to the first floor.

Practice patients are directed to contact the local out of hours provider when the surgery is closed.

The practice operates under a Personal Medical Services (PMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract). These are: Extended Hours Access, Childhood Vaccination and Immunisation Scheme, Learning Disabilities, Facilitating Timely Diagnosis and Support for People with Dementia, Improving Patient Online Access, Minor Surgery, Patient Participation, Rotavirus and Shingles Immunisation, Unplanned Admissions and Influenza and Pneumococcal Immunisations

The practice is part of the North Lambeth GP Federation.

Updated 25 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Riverside Medical Centre on 21 June 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.
• The majority of 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.
• Most 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.

The areas where the provider should make improvement are:

• Undertake a Control of Substances Hazardous to Health risk assessment and act on the recommendations from their legionella risk assessment.

• Ensure that a copy of the practice’s business continuity plan is stored off site.

• Ensure that appropriate training arrangements are in place for non clinical staff who are processing letters from other organisations to ensure that all correspondence which requires clinical input is work flowed, reviewed and actioned appropriately. Ensure that this system is continually reviewed and risk assessed in order to confirm it operates safely and effectively.

• Take action to increase the identification of carers among the practice population to enable them to provide appropriate support and signposting.

• Consider putting in place a formalised business strategy for the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 25 November 2016

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

• Chronic disease clinics were held by the practice’s Physician Associate. Patients at risk of hospital admission were identified as a priority.

• The practice had a high proportion of patients with HIV. Patients were proactively offered screening and the practice ran a joint outreach clinic in partnership with a local hospital and a national charity.

• Diabetes indicators were comparable to local and national averages.

• Longer appointments and home visits were available when needed.

• 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 held virtual clinics with staff from the local hospital for patients with specialists from secondary care.

Updated 25 November 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 Accident and Emergency A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• The practice’s PPG raised concerns about the levels of stress children experienced related to pressures from school. In response the practice took advice from a local children’s service and ran a text shot campaign to promote this service which could provide help for those aged between 13 and 20 with physical or mental health concerns.

• From reviewing patient records we found that children and young people were treated in an age-appropriate way and were recognised as individuals.

• The number of women who had undergone cervical screening was comparable to local and national averages.

• 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.

• The practice held clinics for coil and contraceptive implant fittings.

Updated 25 November 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 offered home visits and urgent appointments for those with enhanced needs.

• The practice nurse undertook Holistic Health Assessments which aimed to address both health and social issues of housebound patients aged over 65 and those over 80.

• Patients who required additional support could be referred to a local service which worked to address needs to elderly patients and facilitate safe and independent living.

Updated 25 November 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.

• 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.

• The practice provided a number of alternative ways for their working age patients to receive medical advice. For instance their website offered self-help information and the practice had increased their outer boundary area in order to enable patients who worked in the area to register and access GP services.

Updated 25 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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  Performance in respect of mental health indicators was comparable to local and national averages.

• The practice only had one patient with dementia and offered that patient a high level of personalised care.

• The practice carried out advance care planning for their patient 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 number of patients with drug dependency issues. These patients were reviewed by a named GP on a monthly basis.

• 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 and was the highest referrer to the local counselling service in the area given the high stress levels experienced by their patient cohort. The practice told us that they actively run searches to try and identify those patient with serious mental health problems who are no longer under the care of the community mental health team to see if they would benefit from referral to alternative community support services.

• The practice had held two stress management workshops in response to PPG and patient survey feedback.

• The practice hosted a substance misuse support worker regularly and all patients with substance misuse issues were under the care of a single GP to ensure continuity.

Updated 25 November 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 those with a learning disability. The practice registered homeless patients and placed alerts on the system which would notify staff of the patient’s circumstances.

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

• The practice worked when required 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.

• The practice had good links with a local domestic violence charity.

• The Lead GP had taken training relating to the risk factors associated with radicalisation.