Petersfield Surgery

Updated 6 April 2017

The practice is based in a converted residential property in Petersfield Avenue, Harold Hill, Romford, Essex, RM3 9PD. The practice has parking spaces available and street parking was unrestricted. There is a bus stop within a few minutes’ walk of the practice and a train station approximately 15 minutes walking distance away.

Petersfield Surgery is one of a number of GP practices commissioned by Havering Clinical Commissioning Group (CCG). It has a practice list of around 6800 registered patients. Havering is in the third least deprived decile out of 10 on the deprivation scale. The practice has a significantly higher percentage of unemployed patients (17%) compared to the local average of 4% and national average of 5%.

The practice staff includes two GP Partners (one male and one female) providing eight sessions a week, three salaried GPs (two male and one female) providing 21 sessions a week. The practice currently has four GP registrars. The nursing team consists of one practice nurse, one nurse Independent Prescriber and one trainee practice nurse who complete a total of 65 hours per week. The clinical team are supported by one healthcare assistant and two phlebotomists. The administration team include a full time practice manager, an assistant practice manager and a team of 12 reception/administrative staff.

The practice is open during the following hours:

Monday - 8am to 6.30pm

Tuesday - 7.45am to 9.30pm

Wednesday - 8am to 6.30pm

Thursday - 8am to 2pm

Friday – 8am to 6.30pm

Appointments are available during the following hours:

Monday - 8.30am to 12pm and then from 3.15 pm to 6.00pm

Tuesday - 8.30am to 12pm and from 4pm to 9.30pm

Wednesday - 8.30am to 12pm and then from 2pm to 4.30pm

Thursday - 8.30am to 12pm

Friday – 8.30am to 12pm and then from 4pm to 6pm

The practice offered extended hours on a Tuesday evening until 9.30pm for working patients who could not attend during normal opening hours. Out of these hours, cover was provided by the local cooperative GP service.

The practice provides the following regulated activities:

• Treatment of disease, disorder or injury;

• Maternity and midwifery services;

• Family planning;

• Diagnostic and screening procedures

• Surgical procedures.

Updated 6 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Petersfield Surgery on 18 January 2017 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 practice annually reviewed all significant events and complaints to identify trends and ensure systems are in place to limit the opportunity for reoccurrence.
• 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.
• 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 did not restrict the number of issues patients could raise in one appointment.
• Patients that walked in without an appointment were seen on the same day. The practice operated a policy that no patient would be turned away without being seen.
• 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:

• Ensure its own policy in relation to recording the use of chaperones in patients’ notes is adhered to.

• Monitor higher than average exception reporting rates for patients with diabetes and mental health concerns.

• Review the two-week referral process to ensure the revised procedure provides an sufficient failsafe to identify missed referrals.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 6 April 2017

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.

• Performance for diabetes related indicators was better than the national average. For example, the percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less (01/04/2015 to 31/03/2016) was 91% compared to the CCG average of 78% and national average of 78%. However, the exception reporting rate 15% compared to the CCG and national average of 9%.

• 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 6 April 2017

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.

• 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, health visitors and school nurses.

Updated 6 April 2017

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 support pack for all patients over the age of 75.

• The Practice invited all patients over 75 years to attend a 30 minute Health Check which included a blood test, full health check and advice regarding diet, nutrients, exercise and available benefits they may be able to claim.

Updated 6 April 2017

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 extended hours to support those could not attend appointments during standard working hours.

• The practice developed an app which allowed patients to book appointments and gain information about the services provided by the practice.

Updated 6 April 2017

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

• 96% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is higher than the national average of 84%. The practice had exception reported 4% compared to the national average of 7%.

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

• The practice had a designated dementia support lead who was responsible for overseeing the treatment of all diagnosed patients.

• The practice 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.

• 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.

Updated 6 April 2017

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, those over 75 years of age living alone and those with a learning disability.

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

• The practice regularly worked 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.

• Patients who were considered vulnerable were given same day priority appointments.

• The practice had identified 1.5% of its patient list were carers.