Archived: Heston Practice Also known as Greenbrook Heston

Updated 9 April 2015

The Heston Practice is a GP practice based in Hounslow in the West London area. The practice is based in a purpose built premises that is shared with other local NHS services. The practice provides NHS primary medical services through an Alternative Provider Medical Services (APMS) contract to 5400 patients in the local community.

The practice population has a higher proportion of younger adults and children and lower proportions of older people. The local area has relatively high levels of deprivation compared to the English average. The practice serves a culturally diverse population, with the majority of patients being from an Asian background. According to the practice they have a high number of young students and a very mobile population.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of: diagnostics and screening procedures; family planning; maternity and midwifery services; and treatment of disease, disorder or injury.

The practice has a lead GP and three salaried GPs of whom one is female and three males. The practice team consists of a practice nurse and a Health care assistant. The practice has a business manager, a practice support manager and six administrative staff.

Appointments were available from 08:00 am to 18:30 pm on weekdays. Extended hours were offered on Thursdays until 21:00 pm. The practice also offered Saturday and Sunday appointments once a month as part of a local agreement with other practices and the 111 service.

Updated 9 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Heston Practice on 18 November 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for all the population groups including older people; people with long term conditions; mothers, babies, children and young people; the working age populations and those recently retired; people in vulnerable circumstances and people experiencing poor mental health.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Risks to patients were assessed and well managed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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.

• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 April 2015

The practice is rated as good for the population group of people with long term conditions.

The practice offered patients diagnosed with conditions such as diabetes, epilepsy, coronary heart disease and chronic obstructive pulmonary disease ongoing care monitoring and they had a lead GP for this. These patients were offered annual flu vaccination as per national guidance and reminders were sent for those who had still not attended, this included a home visit from the GP.

The nurses offered disease management reviews. The nurses referred patients to the GPs if change of medicines was required.

Asthmatic patients had regular reviews which included checks to ensure they were using their nebulisers according to instructions. Diabetes patients were offered a foot assessment and referral to specialist services.

Updated 9 April 2015

The practice is rated as good for the population group of families, children and young people. The practice had a policy to offer same day appointments to children aged 0-12 months. They held weekly child health clinics. This clinic was run by the GPs with the nurse. Women were offered six weeks post-natal checks and the practice worked closely with local maternity services and midwives. The GPs examined babies at eight weeks and vaccinated them at eight weeks. The nurses continued the childhood vaccination programme.

The practice held meetings with the local safeguarding teams where a child was identified as being at risk. Family planning clinics and Sexually Transmitted Disease advice was also offered to young people and teenage mothers.

Updated 9 April 2015

The practice is rated as good for the care of older people.

All patients aged 75 and over had a named GP. Patients were offered an annual health check offered at the practice or at home for those patients that could not travel to the practice. This assessment covered physical health, mobility, nutritional needs and social needs. The practice arranged and held meetings with the district nurses, the end of life care team and the hospice on a regular basis.

Updated 9 April 2015

The practice is rated as good for the population group of the working-age people (including those recently retired and students). Late evening appointments were available for working patients once a week.

Patients aged 40 -74 years were offered health checks in accordance to local and national guidance. The practice offered Well Man and Well Woman checks with the nurse. This was an opportunity to discuss any aspect of general health such as dietary problems, stress, alcohol consumption, smoking and all aspects of women`s health; including breast examination, the menopause, cervical smears and contraception.

Updated 9 April 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). Over 98% of people diagnosed as having mental health issues had received an annual physical health check while all patients with a diagnosed dementia had received yearly checks. The practice maintained a register of patients experiencing poor mental health. These patients were reviewed on a regular basis and had a named GP.

Reviews involved medication, general health, and psychiatric assessment. The practice made appropriate referrals to the community psychiatric team. Leaflets were available on local services that patients could self-refer to such as “Mind”. The practice offered patients l general practice services such as smear testing, breast screening and advice on prostate cancer symptoms.

Updated 9 April 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice had on its list a small number of patients with learning disabilities. The practice had carried out annual health checks for people with learning disabilities and all of these patients had received a follow-up. The check also covered general health, social environment, medication review, mood and lifestyle.

The practice registered patients from the travelling communities. Services were planned according to need recognising that patients would move frequently and as such opportunistic appointments were available. The practice had recognised the needs of different groups in the planning of its services. The practice operated the, `Violet Patients Local Enhanced Service (VPS) for Hounslow, providing primary care services to patients who had been removed from other practices.

Screening services such as smear testing, blood pressure monitoring and smoking cessation advice was offered.