Archived: Forest Road Group Practice

Updated 8 January 2018

The Forest Road Group Practice is located in the London Borough of Enfield. The practice is part of the NHS Enfield Clinical Commissioning Group (CCG) which is made up of 50 practices. It currently holds a Personal Medical Services (PMS) contract (a contract between NHS England and general practices for delivering general medical services) to approximately 12,200 patients.

The Forest Road Group Practice serves a diverse population with many patients attending where English not their first language. The practice has a mixed patient population age demographic with 51% under the age of 18 and 16% over the age of 65. The Forest Road Group Practice is situated in a two storey health centre. It occupies the majority of the second floor. All consulting rooms are easily accessible through wide corridors. There is lift access to the practice. There are currently four full time partners (one male and three female) who undertake between six and seven sessions per week, five salaried GPs (four female and one male) who carry out a total of 24 sessions per week and three GP registrars (two female and one male) who carry out seven sessions each per week offering a total of 78 sessions a week. Practice staff also include two nurses (both female), a healthcare assistant (female), a practice manager, administration and reception staff.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8.30am to 11.30am every morning and 3pm to 5.40pm daily. Following this, GPs conduct telephone appointments and home visits. Further surgery hours are offered on a Tuesday to Thursday from 5.40pm to 6.30pm. in addition to pre-bookable appointment that could be booked up to six weeks in advance, urgent appointments are also available for people that needed them. The practice has opted out of out of hours care and directs patients to a local out of hour’s provider.

The practice is a teaching practice.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures; family planning; maternity and midwifery services; surgical procedures and the treatment of disease, disorder or injury.

The practice provides a range of services including child and health immunisation, minor illness clinic, smoking cessation clinics and clinics for patients with long term conditions. The practice also provides health advice and blood pressure monitoring.

The practice was previously inspected in March 2016 and was rated good overall.

Updated 8 January 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection March 2016 – rated as Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Forest Road Group Practice on 15 November 2017 as part of our routine inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Most patients found the appointment system easy to use however some said that they found it difficult to access the practice by telephone. This is something the practice was asware of and was taking steps to address the issue. Patients were generally able to access care when they needed it.

• Information about services and how to complain was available and easy to understand.

• 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.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Ensure all patients that are carers are identified and supported.

• Continue to work to improve phone access and appointment allocation to patients at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 11 May 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.

• 73% of patients with diabetes had received a blood pressure check in the preceding 12 months, compared to the national average of 78%.Longer appointments and home visits were available when needed.

• 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.

Updated 11 May 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 relatively high for all standard childhood immunisations.

• 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.

• 72% of patients diagnosed with asthma had an asthma review in the last 12 months, compared to the national average of 75%.

• The practice’s uptake for the cervical screening programme was 80%, which was comparable to the national average of 81%.

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

• Consent was not always sought when a family member other than a parent presented a child for immunisations.

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

Updated 11 May 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 provided a service to two care homes. We spoke to the homes who were both happy with the service provided.

• The practice proactively contacted all patients over 65 who had been admitted to hospital following their discharge.

• Patients were contacted within three days of any hospital accident and emergency attendance to have their needs reassessed by the practice.

Updated 11 May 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.

Updated 11 May 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.

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

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

• The practice works with a local drug and alcohol service to provide a shared service to patients. This includes the facility for patients to see their key worker at the practice.

• 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.

Updated 11 May 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.

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

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

• The practice works with a local drug and alcohol service to provide a shared service to patients. This includes the facility for patients to see their key worker at the practice.

• 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.