Archived: The Wick Health Centre

Updated 26 January 2017

The Wick Health Centre is one of the member GP practices in the City and Hackney Clinical Commissioning Group (CCG). The practice is also a member of the Well Consortium, a CCG sub-group of eight GP practices in the local area.

The practice provides GP primary care services to approximately 5,800 people living in the Homerton area, London Borough of Hackney. Services are provided under a General Medical Services (GMS) contract with NHS England. A General Medical Services (GMS) contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice has a main surgery and a branch surgery which is located approximately 10 minutes’ drive or a 20 minute walk away. The branch surgery was not visited as part of the inspection.

Information published by Public Health England indicates the practice is located in one of the most deprived areas in England. This information also shows that Income Deprivation Affecting Older People (IDAOPI) is 45% and is higher than the CCG average of 41% and the national average of 16%. Income Deprivation Affecting Children (IDACI) is 42% (CCG average 32%, national average 20%). At 77 years, male life expectancy is lower than the England average of 79 years; and at 81 years, female life expectancy is lower than the England average of 83 years.

There are currently two male GP partners, one of whom works full time and one part time. There are two female part time female salaried GPs and one long term part time male locum GP. The practice provides a total of 30 GP sessions per week. The clinical team is completed by a part-time practice nurse, a part-time trainee practice nurse and a one health care assistant who is also trained as a phlebotomist (Phlebotomists are specialist healthcare assistants who take blood samples from patients for testing in laboratories). There is also a practice manager and five administrative and reception staff.

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

The practice opening hours for the main surgery are:

Monday 8:30am to 12:30pm and 1:30pm to 6:00pm

Tuesday 8:30am to 12:30pm and 1:30pm to 6:00pm

Wednesday 8:30am to 12:30pm and 1:30pm to 6:00pm

Thursday 8:30am to 12:30pm

Friday 8:30am to 12:30pm and 1:30pm to 6:00pm

Saturday Closed

Sunday Closed

The opening hours for the branch surgery are:

Monday 9:30am to 12:00pm and 6:00pm to 7:30pm

Tuesday 9:30am to 12:00pm and 6:00pm to 7:30pm

Wednesday 9:30am to 12:00pm and 6:00pm to 7:30pm

Thursday 9:30am to 12:00pm and 2:00pm to 4:30pm

Friday 9:30am to 12:00pm and 6:00pm to 7:30pm

Saturday Closed

Sunday Closed

There are arrangements in place with a suitable provider (City & Hackney Urgent Healthcare Social Enterprise) to deliver services to patients outside of the practice’s working hours.

Patients can book appointments in person, on-line or by telephone. Patients can access a range of appointments with the GPs and nurses. Face to face appointments are available on the day and are also bookable up to six weeks in advance. Telephone consultations are offered where advice and prescriptions, if appropriate, can be issued and a telephone triage system is in operation where a patient’s condition is assessed and clinical advice given. Home visits are offered to patients whose condition means they cannot visit the practice.

The practice has opted not to provide out of hours services (OOH) to patients and these were provided on the practice’s behalf by CHUHSE (City & Hackney Urgent Healthcare Social Enterprise). The details of the how to access the OOH service are communicated in a recorded message accessed by calling the practice when it is closed and details can also be found on the practice website.

The practice provides a wide range of services including clinics for diabetes, weight control, asthma, contraception and child health care and also provides a travel vaccination clinic. The practice also provides health promotion services including a flu vaccination programme and cervical screening. The practice teaches medical students from a local university hospital.

The practice had not previously been inspected.

Updated 26 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Wick Health Centre on 8 November 2016. Overall the practice is rated as Good.

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

• Risks to patients were assessed although not all recommended mitigating actions had been carried out and not all electrical and clinical equipment had been tested to make sure it was safe to use or working properly.
• There were processes in place to manage medicines but there were gaps in how processes were implemented, particularly in the management of prescriptions.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment but two consulting rooms had not been equipped with privacy curtains.
• 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.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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 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

• Consider maintaining records of internal chaperone training given to members of staff.
• Review procedures for managing medicines to include putting steps in place to undertake earlier reviews of uncollected prescriptions and consider involving GPs in this process.
• Continue to safely manage stocks of medicines held on patient’s behalf including keeping a record of batch numbers so that specific items are identifiable in the event of a safety alert.
• Ensure blank prescriptions pads are handled in accordance with national guidance and that stock levels of handwritten prescription pads reflect the needs of the practice.
• When undertaking calibration of clinical equipment and safety tests of electrical equipment, consider using an inventory schedule to ensure that all equipment is included.
• Consider implementing a programme of quality improvement initiatives to improve patient outcomes which reflects the needs of the practice population.
• Review how carers are identified and recorded on the clinical system to ensure information, advice and support is made available to all.
• Continue to address the lack of privacy curtains in consulting rooms with the owners of the building.
• Continue to address issues identified in the national GP survey in order to improve patient satisfaction around involvement in care panning and making decisions about their care and treatment.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 26 January 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 against indicators for diabetes care was in line with local and national averages. The practice provided a weekly clinic led by a diabetic nurse specialist and fortnightly clinics with a dietician with a special interest in diabetes.

• Longer appointments and home visits were available when needed.

• Patients had a structured annual review to check their health and medicines needs were being met. The practice held multi disease management clinics for those patients with the most complex needs, and worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 26 January 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.

• The practice’s uptake for the cervical screening programme was 76%, which was comparable to the CCG average of 81% and the national average of 82%.

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

• The practice was an active participant in a programme to promote better sexual health amongst young people and provided confidential contraceptive advice and access to chlamydia testing kits for all young people aged under 25 including those who were not registered at the practice.

Updated 26 January 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.

• Housebound patients were provided with a quarterly home visits as a matter of routine.

• The practice worked closely with other community health services to help patients at risk of unplanned or avoidable hospital admissions to be treated in their own homes.

Updated 26 January 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.

Updated 26 January 2017

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

• 86% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG average of 88% and the national average of 84%.
• 87% of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• 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 26 January 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 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.