Chobham and West End Medical Practice

Updated 23 March 2017

The Chobham & West End Medical Centre has a main surgery in Chobham with a branch site in West End, both are purpose built properties. At the time of our inspection there were 11,100 patients on the practice list.

The practice has six GP partners and three salaried GPs (one male and eight female), which is equivalent to nearly 6 whole time GPs. The practice employs a team of one nurse practitioner as a community matron, three nurses, three health care assistants, a practice manager, a deputy practice manager, reception and administration staff. The Chobham surgery is open from 8am to 6.30pm Monday to Friday; West End is open from 8am to 6.30pm Monday, Wednesday and Friday and 8am to 1pm Tuesday and Thursday. Patients requiring a GP outside of normal hours are advised to call the NHS 111 service or 999 for medical emergencies. The practice has a GMS (General Medical Services) contract and offers enhanced services for example; various schemes for immunisation and facilitating timely diagnosis and support for people with dementia.

The service is provided at the following locations:

The Surgery

16 Windsor Road, Chobham

Woking, Surrey

GU24 8NA

West End SurgeryLucas Green RoadWest EndSurreyGU24 9LU

The practice population has a higher number than average of patients 10 to 14 years and 40 to 59 years, it has a lower number than average of patients 0 to 4 years and 20 to 39 years. It also has a slightly lower than average percentage of patients with long standing health conditions and higher than average number of patients with caring responsibilities.

Updated 23 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chobham and West End Medical Practice on 1 December 2015. The overall rating was good. During the inspection we found breaches of legal requirements and the provider was rated as requires improvement under the safe key question. Following this inspection the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

• Ensuring that all complaints and safety incidents and their investigation were recorded thoroughly and that learning was shared appropriately to support improvement.
• Ensuring that blank prescription forms were stored securely and tracked.
• Ensuring that clinical waste was stored securely.

The full comprehensive report on the 1 December 2015 inspection outcome can be found by selecting the ‘all reports’ link for Chobham and West End Medical Practice on our website at www.cqc.org.uk.

An announced focused inspection was carried out on 7 February 2017. This inspection was to verify if the practice had carried out their action plan to meet the legal requirements in relation to the breaches in regulations that we had identified in our previous inspection on 1 December 2015. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

We saw that the practice had made significant improvements since our December 2015 inspection. Overall the practice is rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting, recording and investigating significant events. Learning was shared with appropriate staff to support improvement.
• Blank prescription forms were being tracked and stored securely.
• Clinical waste was stored securely.

At our previous inspection on 1 December 2015, we found that the practice was performing below local and national averages for monitoring and reviewing patients experiencing poor mental health, uptake of flu vaccines and childhood immunisations We also noted that the practice was not maintaining a complete contemporaneous record for all patients.

During our inspection 7 February 2017 we saw;

• The practice was maintaining complete contemporaneous medical records for all patients.
• • The practice had a schedule in place to ensure regular reviews and monitoring of patients that were vulnerable or experiencing poor mental health.

The areas where the provider should make improvement are:

• Continue regular review of patient treatment outcomes to ensure increased uptake in childhood immunisations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

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.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and an annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice ran anticoagulation monitoring clinics.

Updated 3 March 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. Immunisation rates were mixed with 12 month immunisation rates lower than national average but 24 months and 5 years immunisation rates comparable with national average or higher.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Cervical screening rates were comparable with the national average.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

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

Updated 3 March 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.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice took part in the admission avoidance scheme where the most vulnerable patients were identified and personalised care plans were agreed.

• We saw evidence that emergency admissions to hospital were reviewed by the surgery.

Updated 3 March 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 offered Saturday morning appointments to increase access for people who could not attend the surgery during normal surgery hours.

Updated 3 March 2016

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

• 71.8% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months which is lower than the CCG average of 83.1% and the national average of 84%.

• Exception reporting was higher than CCG and national averages for five out of six mental health indicators in the 2014-2015 QoF data. For example the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood pressure in the preceding 12 months practice exception reporting was 32.3%, compared with a CCG average of 7.3% and a national average of 9%.

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

• It 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.

• Reception staff had a good understanding of how to support people with mental health needs and dementia.

Updated 3 March 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, travellers and those with a learning disability.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told 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.