Report for the Royal Borough of Kingston Health Overview Panel (HOP) on GP Provision in Kingston.
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Report for the Royal Borough of Kingston Health
Overview Panel (HOP) on GP Provision in Kingston.
Author: Kathryn MacDermott, Director Primary Care & Planning, Kingston & Richmond CCGs
Contact: Kathryn.macdermott@kingstonccg.nhs.uk
Contributions from and thank you to:
KCCG Primary Care Team
KCCG Performance & Information Team
SWL Primary Care Contacting Team
1Contents
1. GP Provision in Kingston - background...........................................................................................4
2. Kingston Medical Services – the local primary care strategy .........................................................4
2.1 Quality in Primary Care – local engagement in Kingston Medical Services ..................................5
3. The GP Forward View .....................................................................................................................6
3.1 Investment....................................................................................................................................7
3.2 Workforce.....................................................................................................................................7
3.3 Work load .....................................................................................................................................7
3.4 Infrastructure................................................................................................................................8
3.5 Care redesign ..........................................................................................................................8
4. The South West London STP...........................................................................................................9
5. Services provided by GP Practices in Kingston ...............................................................................9
5.1 Contract by contract type...........................................................................................................10
5.2 Core primary care medical services............................................................................................11
5.3 Locally Commissioned Services ..................................................................................................11
5.4 National Directed Enhanced services .........................................................................................12
5.5 Kingston Medical Services – local KPIs........................................................................................13
5.6 GPs with Specialist Interest ........................................................................................................14
6. Access to general practices...........................................................................................................15
7. Extended Primary Care Services ...................................................................................................17
7.1 Weekend additional capacity .....................................................................................................17
7.2 National DES extended hours .....................................................................................................17
8. Urgent Primary Care services .......................................................................................................21
8.1 Urgent Treatment Centres..........................................................................................................21
8.2 GP Out of Hours Services............................................................................................................22
8.3 NHS 111 ......................................................................................................................................22
9. Primary Care data .........................................................................................................................23
9.1 Numbers and ages of registered patients ..................................................................................23
9.2 Deprivation by practice ..............................................................................................................25
9.3 Ethnicity by practice .............................................................................................................26
9.4 Usage of GP appointments .........................................................................................................27
10. General practice workforce ......................................................................................................29
10.1 Kingston primary care workforce as of March 2016: ...............................................................29
210.2 Patient to GP Ratio ...............................................................................................................30
10.3 Total Health Care professionals per practice FTE .....................................................................31
10.4 GPs by Age Band .......................................................................................................................32
11. The GP Patient Survey ..............................................................................................................33
11.1 Overall experience of GP surgeries...........................................................................................33
11.2 Patient experience of telephone access ...................................................................................34
11.3 Success in getting an appointment...........................................................................................34
11.4 Waiting time at the GP surgery ................................................................................................35
11.5 Patient perception of care ........................................................................................................36
11.6 Patient satisfaction with opening hours ...................................................................................36
12. Care Quality Commission (CQC) ratings ...................................................................................37
13. Primary Care Governance.........................................................................................................39
31. GP Provision in Kingston - background
There are currently 22 practices listed as members of Kingston CCG. One practice whilst a
member of Kingston CCG is geographically located in the borough of Merton. At this point in
time three practices also have branch surgeries. This means that in Kingston there are 26
locations at which patients can see a GP. In addition to the individual GP practices Kingston
also provides three extended primary care services that offer 8 to 8, 7 day a week access to
a GP and/or nurse appointment.
2. Kingston Medical Services – the local primary care strategy
The local primary care strategy covers delivery of the GP Forward View transformation of
primary care whilst aiming to provide the same services across all practices in Kingston. To
achieve this KCCG is investing additional money into Kingston general practices through a
range of locally developed services known as KPIs. In 2016/17 the additional investment was
£1m. In 2017/18 the additional investment is £1.5m. The intent is to be able to invest an
additional £2m in 2018/19 to achieve the transformation and equalisation of services.
However, this level of additional investment is only sustainable if we can change the flow of
patients into hospitals, change patient behaviours and move money around the local
healthcare system.
The local Kingston Medical Services strategy invests in a range of additional services
including extended primary care services, primary care mental health, paediatric same day
appointments, supports practices to make informed referral decisions, supports practices
identify vulnerable patients that require additional care and/or referral to Kingston
Coordinated Care, audiology services, respiratory services, and supports practices set a
minimum number of GP appointments based on list size (not currently stipulated in the
GMS contract). The local strategy is in the middle of being rolled out and the GMS practices
are already delivering a range of the local KPIs. The PMS practices will be moving from their
existing PMS KPIs to the new Kingston Medical Services local KPIs for the 1st April 2018. The
table below sets out the current pattern of delivery for the new KPIs:
4Weekend Additional
Paediatric Same Day
Primary Care Access
Early intervention
Respitatory (new)
Risk Stratification
Mental Health &
Standard (new)
Management
GPFV (new)
Audiology
Capacity
Referral
appts.
Practice
Berrylands Surgery
Brunswick Surgery
Canbury Medical Centre
Central Surgery
Chessington Park Surgery
(Merrick Centre)
Churchill Medical Centre
Claremont Medical Centre
Fairhill Medical Practice
Groves Medical Centre
Holmwood Corner Surgery
Hook Surgery (Merrick centre)
Kingston Health Centre
Langley Medical Practice
Manor Drive Medical Centre
Orchard Practice
Red Lion Surgery
(Mediventure Ltd)
Roselawn Surgery
St Alban’s Medical Centre
Sunray Surgery
Village Surgery
West Barnes Surgery
2.1 Quality in Primary Care – local engagement in Kingston Medical Services
Kingston CCG launched a public engagement programme at its AGM in September. The aim
is to have a public conversation about the quality of locally provided general practice and
community pharmacy across Kingston & Richmond CCGs.
It has been 18 months since Kingston CCG took on the responsibility for commissioning
primary care medical services and we included a commitment in our commissioning
intentions to actively engage the local population in the design of local services.
Kingston CCG completed an engagement programme in primary care in 2015. The feedback
from this programme helped inform the primary care strategy – Kingston Medical Services.
We wish to build on what local people have already told us about local GP practices and
pharmacies, and develop a set of quality pledges for primary care. To do this we will be
5talking to patients, carers, local people, clinicians and staff, to understand what good quality
looks like. Over the next four months KCCG will be talking to people across Kingston and
asking ‘what matters most to you when visiting your GP and/or local pharmacy?
We also want the perspective of clinicians and staff working in local GP practices and
pharmacies about what good quality primary care looks like and what matters most to them
about the services they deliver.
3. The GP Forward View
Kingston Medical Services sits alongside the General Practice Forward View (GPFV)
published in April 2016 by NHS England, with support from Royal College of GPs (RCGP) and
Health Education England. The GPFV sets out a substantial 5 year package of investment and
transformation that aim to support practices respond to the changing environment. It sets
out a plan to stabilise and transform general practice, improving services for patients and
investing in new ways of providing primary care. The key actions set out in the plan include:
accelerated funding of primary care; expanding and supporting GP and wider primary care
staffing; reducing the burden on practices to help release time for patient care; develop the
primary care estate and invest in better technology and a major programme of
improvement support to practices.
The illustration below attempts to illustrate how the delivery of the GP Forward View
intends to impact on general practice, patients and the wider healthcare system.
Strengthening General
Practice Community Collective
Services
Working
Access Hub
Demand Management Standard
• Self-help e.g. nhs.uk Contract
• Better sign posting • Stabilise practices
o Minor Ailments • Support for stressed GPs
o Social prescribing • Resilience programme
• Enhanced remote care • Development programme
• Care Planning Approach • Workforce expansion
• Reformed 111/Urgent Care Greater
• Streamlined processes Specialist
Support
Proportionate regulation
Streamlined payment systems
Review of requirements e.g. QOF/AUA
6The GP Forward View is structured into five sections:
1) Investment
2) Workforce
3) Workload
4) Practice infrastructure
5) Care redesign
3.1 Investment
The GP Forward View states “by 2020/21 recurrent funding to be increased by an estimated
£2.4 billion a year, decisively growing the share of spend on general practice services”. This
is clearly positive news and taken with Kingston CCGs strategy to invest in Kingston Medical
Services represents a unique opportunity in Kingston to general practices to support the
significant redesign of care pathways and patient flows.
The new funding formulae for general practices (to replace the existing Carr-Hill formulae) is
proposed and being worked by up NHSE with the BMA and is designed to take into account
‘atypical’ population lists, i.e. practice lists with significant older populations, high rates of
students, black and minority ethnic communities etc. This work is expected to be completed
in the summer of next year.
3.2 Workforce
The GP Forward View recognises that there is a significant workforce challenge for primary
care and refers to new incentives for training, recruitment, retention and return to practice.
The ambition is to double the workforce and ongoing work across London to understand
how this could be achieved.
There are a number of positive initiatives proposed including the health & wellbeing of GPs,
training ‘hubs’, practice nurse development, leadership development, and piloting clinical
pharmacists in general practice. Across SWL the CCGs are collaborating on the development
and delivery of a shared workforce strategy.
3.3 Work load
“Releasing Time for Patients” is a development programme to support general practice
‘release time’ by enabling the care of patients to be provided by the appropriate
professional, at the right time, in the right place. This refers predominantly to the care and
self-management of people living with long term conditions.
7The GP Forward View suggests that CCGs look to local community pharmacy to help with
patients with long term conditions and minor ailments. This is a key element within the
Kingston plan, included in the extended primary care services communications materials
and a key question in the current quality in primary care engagement programme.
3.4 Infrastructure
The infrastructure section covers both estates and technology. The GPFV signalled a change
in the way CCGs could apply for capital funding for estates bids, establishing the Estates and
Technology Transformation Fund (ETTF). Kingston CCG currently has a proposal in the ETTF
‘round; for a new primary care centre on the Kingston Hospital site.
Most of the focus on infrastructure within the GPFV focusses on changing the way people
can access general practice through technology. This includes:
Technology that enables self-care and self-management for patients
Helps to reduce workload in practices
Helps practices who want to work together to operate at scale
Supports greater efficiency across the whole system
Support uptake of online consultation systems
Digital Primary Care Maturity Index – sets out the support general practice can
expect from IT services
3.5 Care redesign
Care redesign focusses on enhanced primary care access (8 to 8, 7 days a week), and the
integration of core general practice with out of hours and urgent care services. This element
has been recently expanded on in the Urgent Care Guidance, and is informing the extended
primary care services commissioning intentions for 2018/19 onwards.
The GPFV lists 10 high impact actions supporting care redesign and releasing capacity for
practices. These include:
Active signposting
New consultation types
Reduce DNAs (did not attends)
Develop the team
Productive workflows
Personal productivity
Partnership working
Social prescribing
Support self-care
Develop Quality Improvement expertise (QI)
84. The South West London STP
The South West London (SWL) Sustainability & Transformation plan includes a chapter on
general practice and sets out the plan to integrate primary care and community services.
However primary care is threaded throughout the strategy and is the bedrock of the out of
hospital transformation of care.
The framework of the SWL STP chapter on general practice is currently structured around
the 17 London specifications (Access, Coordinated & Proactive). This framework overlaps in
a number of ways with the delivery of Kingston Coordinated Care.
5. Services provided by GP Practices in Kingston
Nationally there are three types of contracts that a general practice can sign up to. There
are two contract types in place for general practices in Kingston, GMS & PMS.
The GMS contract covers the delivery of general medical services (GMS). It is the nationally
set NHS contract between NHSE and a practice, not the individual GP. This came into force
on 1st April 2004. Services in the GMS contract are split into three groups: essential,
additional and enhanced.
Essential services are mandatory. Practices must provide essential services for people who
are sick or perceive themselves to be sick with conditions from which recovery is expected,
chronic disease management and general management of terminally ill patients.
Additional services are ‘expected’ under the GMS contract but Practices have the option to
opt out. Additional services include cervical screening, contraceptive services, vaccination
and immunisation, child health surveillance, maternity services (including intra partum care)
and some minor surgery procedures.
Enhanced services can be either essential or additional services that are delivered to a
higher standard, or extra/additional, specialised services, such as minor surgery or extended
hours. These are known as Directed Enhanced Services (DES). Directed Enhanced Services
are voluntary and NHSE commissions the national Directed Enhanced Services (on behalf of
the CCGs).
Directed Enhanced Services are NHSE defined and funded services that practices can opt to
provide. An example is the extended hours DES which a number of Kingston practices
provide. Additionally, Kingston CCG commissions Locally Commissioned Services (LCS) that
are designed and funded locally to meet local population needs.
9PMS contracts build on the GMS contract. A practice with a PMS contract has contractually
agreed to provide additional services as part of their core contract.
GMS and PMS contracts were introduced in 2004 as part of The NHS Plan. The intention was
to move away from simply paying practices on the number of registered patients by
introducing a number of quality indicators. The basic principle is that high quality practices
receive additional resources to support continuation of quality services.
5.1 Contract by contract type
Kingston CCG is made up of a number of practices, some of which include branch surgeries.
These are listed below by contract type as requested:
Practice Branch GMS
Brunswick Surgery GMS
Canbury Medical Centre Berrylands GMS
Claremont Medical Centre GMS
Groves Medical Centre GMS
Hook Surgery (Merrick centre) GMS
Kingston Health Centre GMS
Manor Drive Medical Centre GMS
Orchard Practice Part of Churchill Medical GMS
St Alban’s Medical Centre GMS
West Barnes Surgery GMS
Practice PMS
Central Surgery PMS
Chessington Park Surgery (Merrick Centre) PMS
Churchill Medical Centre Surbiton & Tudor Drive PMS
Fairhill Medical Practice Fairfield & University PMS
Holmwood Corner Surgery PMS
Langley Medical Practice PMS
Red Lion Surgery (Mediventure Ltd) PMS
Roselawn Surgery PMS
Sunray Surgery PMS
Village Surgery PMS
105.2 Core primary care medical services
All Kingston general practices provide the essential GMS services. In addition half of
Kingston practices also provide additional services as part of the PMS contract. The
additional services provided by a PMS practices includes:
1) A stretch target (i.e. higher than the GMS target) for childhood immunisation target.
PMS practices are expected to achieve 95% coverage of all childhood immunisations
DTP, MMR, Hib, Men C, PCV, etc.
2) Stretch target on QOF (Quality Outcomes Framework). PMS practices are expected
to achieve greater than 950 QOF points.
3) Stretch target on cervical cytology (screening). PMS practices are expected to
achieve 85% or more coverage of women aged between25-64 years of age.
4) Stretch target on flu & pneumococcal vaccination for patients aged 65 and over.
PMS practices are expected to achieve 75% coverage of flu vaccination cover for
patients who meet the DH criteria for flu immunisation.
5) Mental Health: PMS practices are expected to achieve 65% of patients diagnosed
with dementia provided with an annual physical check-up including a regular review
of any antipsychotic medication prescribed.
6) Obesity: The practice will offer a health check for 95% of new registrations over age
18 to include waist, weight and height measurements and offer referral to local
weight management and exercise referral schemes where higher risks are identified
and schemes are available e.g. Weigh-to-Go, Rosemary Conley, Get Active, Walk-4-
Life and Cyle-4-Life.
7) Choose and Book: PMS practices are required to continue to deliver Choose and
Book.
8) Carers: Have a carer’s register, routinely identify carer’s, have a ‘carer’s liaison
officer’.
9) PMS practices are required to provide data on the delivery of any of the DH Vital
Signs Targets (limit up to 3). The data is fed back to child health for reporting
coverage to the DH for public health information
5.3 Locally Commissioned Services
Kingston CCG also invests in locally commissioned services, which all practices can opt into
delivering. These local services are designed to meet the needs of the local population and
can be different across different boroughs. The range of locally commissioned services
provided by Kingston practices are illustrated in the table below:
11Kingston Locally Commissioned Services
Alcohol (PH LCS)
Complex Wound
Misuse (PH LCS)
Leg Ulcer Care
Sexual Health
ABPM (blood
Phlebotomy
Ring Pessary
Shared Care
monitoring)
Prescribing
Substance
Diabetes
pressure
(PH LCS)
Vascular
COPD
Care
Practice
Berrylands Surgery
Brunswick Surgery
Canbury Medical Centre
Central Surgery
Chessington Park Surgery
(Merrick Centre)
Churchill Medical Centre
Claremont Medical Centre
Fairhill Medical Practice
Groves Medical Centre
Holmwood Corner Surgery
Hook Surgery (Merrick centre)
Kingston Health Centre
Langley Medical Practice
Manor Drive Medical Centre
Orchard Practice
Red Lion Surgery (Mediventure
Ltd)
Roselawn Surgery
St Alban’s Medical Centre
Sunray Surgery
Village Surgery
West Barnes Surgery
5.4 National Directed Enhanced services
In addition to locally commissioned services, that are developed and paid for locally, there
are a range of nationally developed enhanced services that are managed by NHSE. Kingston
practices also deliver a range of the nationally directed enhanced services illustrated below.
Further detail on directed enhanced services can be found in section 6.2:
12National Directed Enhanced Services
Out of Area
Patient with
Registration
Difficulty
Extended
Learning
Surgery
Hours
Minor
Practice
With
Berrylands Surgery Canbury
Brunswick Surgery
Canbury Medical Centre
Central Surgery
Chessington Park Surgery
(Merrick Centre)
Churchill Medical Centre
Claremont Medical Centre
Fairhill Medical Practice
Groves Medical Centre
Holmwood Corner Surgery
Hook Surgery (Merrick centre)
Kingston Health Centre
Langley Medical Practice
Manor Drive Medical Centre
Orchard Practice
Red Lion Surgery
(Mediventure Ltd)
Roselawn Surgery
St Alban’s Medical Centre
Sunray Surgery
Village Surgery
West Barnes Surgery
5.5 Kingston Medical Services – local KPIs
Unique to Kingston is the investment that KCCG is putting into primary care through
Kingston Medical Services. This new investment is enabling the roll out a suite of new
services to all practices. Kingston Medical Services will ensure that all practices are able to
offer the same range of services to their patients regardless of the type of national contract
the practice holds with NHSE (i.e. GMS or PMS).
Kingston Medical Services has to demonstrate that it can achieve a shift in patient activity to
enable the non-recurrent investment currently underpinning Kingston Medical Services to
become recurrent.
13GMS PMS
Practice Essential Additional LCS KPIs
Services Services
Berrylands Surgery
Brunswick Surgery
Canbury Medical Centre
Central Surgery
Chessington Park Surgery (Merrick
Centre)
Churchill Medical Centre
Claremont Medical Centre
Fairhill Medical Practice
Groves Medical Centre
Holmwood Corner Surgery
Hook Surgery (Merrick centre)
Kingston Health Centre
Langley Medical Practice
Manor Drive Medical Centre
Orchard Practice
Red Lion Surgery (Mediventure Ltd)
Roselawn Surgery
St Alban’s Medical Centre
Sunray Surgery
Village Surgery
West Barnes Surgery
5.6 GPs with Specialist Interest
Kingston has a number of GPs trained in specialised areas. These are known as GPs with a specialist
interest (GPwSI). We currently have eight GPwSI and a number of them are specialist in more than
one area.
Specialist GP advice is available on:
Dermatology
Dementia
Neurology
Urology
Vasectomy
Minor Surgery
14GPs with a specialist interest provide this additional service through a number of clinics that a
patients GP can refer a patient to.
6. Access to general practices
The GMS contract describes core general practice hours as 8am to 6.30pm. However the
GMS contract does not stipulate that the practice must be open for all core hours only that practices
must provide essential services to meet the 'reasonable needs' of their patients.
The table below illustrates the current opening hours of practices in Kingston and illustrates
the range of hours available. This range is due to a number of factors:
The extended hours provided under the national extended hours enhanced service
If the practice has chosen to deliver the Kingston Weekend Additional Capacity KPI
that provides for Saturday morning appointments.
If a practice closes for lunch
If a practices closes to allow for staff training time
There has been recent national attention paid to the contractual requirement to be open for
the full core hours and future revisions to the GMS contract may clarify this point.
15Kingston GP Hours
Practice provides cover outside of core opening
Practice Hours (core hours are 8.00 to 18.30) GP practices open on Saturdays Online services
times (8am - 18.30pm)
Berrylands Surgery Extended hours Mon & Fri only Yes. Extended hours Mon & Fri only Yes Yes
Brunswick Surgery 7.30am - 18.30 Mon to Fri, 7.30am to 19.30 Wed Yes. 7.30am - 18.30 Mon to Fri, 7.30am to 19.30 Wed No Yes
Canbury Medical Centre Extended hours Mon & Tues only Extended hours Mon & Tues only Yes Yes
Central Surgery 7.30am - 20.00 Mon to Thur, 7.30am to 18.00 Fri Yes. 7.30am - 20.00 Mon to Thur, 7.30am to 18.00 Fri No Yes
Chessington Park Surgery
8am - 13.00 Mon to Fri, 14.00 to 18.30 Mon, Tues, Fri, 14.00 to 20.00 Wed 7 Thur No Every 2nd Sat am No
Churchill Medical Centre,
8.00am - 20.00 Mon to Fri 8.00am - 20.00 Mon to Fri 8.30am - 11.10 Yes
Kingston
Churchill Medical Centre, 8.30am - 12.00, 16.00 - 18.00 Mon, Tues, Thur, Fri. Wed
Wed eve to 20.00 No Repeat Prescribtions only
Surbiton 8.30am - 12.00, 15.00 - 17.00, 18.00 - 20.00
Churchill Medical Centre, Tudor
8.30am - 12.00 Mon to Fri. 16.00 - 18.00 Mon to Thur. No No Repeat Prescribtions only
Br
8.30am to 13.00 Mon, Tues, Thur, Fri. Wed 8.30 am to
Claremont Medical Centre Wed eve to 19.50. Thur eve to 19.20. Fri eve to 18.50 Yes Yes
19.50. Thur 14.10 - 19.20. Fri 14.10 - 18.50
Fairhill Medical Practice 8.00am - 18.30 Mon to Fri No No Yes
Fairhill Branch 8.00am - 18.30 Mon to Fri No No Yes
Fairhill University Branch 8.00am - 17.30 Mon to Fri No No Yes
Groves Medical Centre 8.30am - 13.00, 14.00 - 18.30 Mon to Fri 7.00am on Tues & Thurs. 20.00 on Wed eve Yes Repeat Prescribtions only
8.50am to 11.30, Mon, Thur & Fri, 8.30am to 11.30 Tues &
Holmwood Corner Surgery wed. 16.00 - 18.00 Mon. 15.00 - 19.30 Tues & Thur. 14.00 - Tues & Thurs eve to 19.30. 9.00 - 10.30 Yes
17.30 Wed eve. 15.00 - 18.00 Fri eve.
Hook Surgery 8.00am - 13.00, 14.00 - 19.00 Mon to Fri Eves to 19.00 Every 2nd Sat am 8.30 - 10.30 Yes
Kingston Health Centre 8.00am - 18.30 Tues to Thur, 7.15am - 18.30 Mon & Fri. Mon & Fri 7.15 am start Yes Yes
Langley Medical Practice 8.00am to 18.30 Mon to Fri No No Yes
9.00 - 11.00 Mon to Fri, 15.30 - 18.00 Mon, Tues, Thur &
Manor Drive Medical Centre Mon eve to 20.00 Yes Yes
Fri, 17.00 on Wed, 18.30 - 20.00 Mon eve.
8.30 - 11.30 Mon & Thur, 9.00 - 11.30 Tues, 9.30 - 11.30
Red Lion Surgery (Mediventure
Wed, 8.30 - 10.30 Fri, 16.30 - 18.30 Mon & Wed, 16.30 - Tues eve, 18.30 - 19.30, Fri eve 18.30 - 19.00 No Repeat Prescribtions only
Ltd)
19.30 Tues, 16.30 - 19.00 Fri.
Orchard Practice 7.30 - 18.30 Mon, Wed & Fri, 7.30 - 20.00 Tues & Thur 7.30 am, Tues & Thur eve to 20.00 Yes Yes
8.30 - 13.00 Mon to Fri, 14.00 - 19.30 Mon, 14.00 - 19.00
Roselawn Surgery Mon, Tues, wed & Fri extended eve hours. No Yes
Tues, Wed & Fri.
St Alban’s Medical Centre 7.30 - 18.00 Mon to Fri, closed 12.00 - 13.30. No No Yes
Sunray Surgery 8.00 - 13.00, 15.00 to 18.30 Mon - Fri Mon eve 20.00 No No
Village Surgery 8.30 - 18.30 Mon to Fri, 19.30 Wed & Thur. Wed & Thur eve to 19.30. No Repeat Prescribtions only
To 19.00 Mon to Fri, Wed am 7.30 to 8.00, Fri eve
West Barnes Surgery 8.00 - 19.00 Mon - fri Yes Yes
18.30 to 19.40.
167. Extended Primary Care Services
Kingston has three extended primary care services across Kingston that provides access to GP
and/or Nurse Appointments, 8 to 8, 7 days a week.
The three services are based at:
Surbiton Health Centre
Kingston Health Centre
Merritt Health Centre
Access to the weekday appointments are made by the patients GP through their clinical
system. The appointments for each week (Monday to Friday) are available to be booked
from Monday morning.
For access to weekend appointments patients can book via a single shared phone number.
All callers will have access to the appointment available in all three extended primary care
services, providing an element of patient choice. The weekend extended services is not
advertised as a walk-in service. Where patients do walk-in they are allocated the next free
appointment slot.
The extended primary care services and all Kingston practices are on the same clinical
system (EMIS). This ensures that no matter where a patient is seen the clinician will be able
to access their clinical records.
7.1 Weekend additional capacity
Weekend Additional Capacity is the name given to one of the local KPIs in the Kingston
Medical Services contract. This KPI requires a practice to be open on a Saturday morning
with a minimum number of appointments available (based on list size). There are two
options for delivery of the Weekend Additional Capacity KPI. One requires that practices
offers booked appointments, up to 5 days in advance. The second option requires practices
to offer both booked in advance and same day appointments. Practices can choose which
option best meets the needs of their local population.
7.2 National DES extended hours
The national DES (directed enhanced services) extended hours is commissioned and
managed by NHSE. For Kingston CCG as a level 3 commissioners we would want to ensure
that the extended provision provided through the national DES, local KPIs and the extended
primary care services formed a holistic and seamless approach to extended hours that did
not duplicate or create gaps in service provision for Kingston residents.
17The next two tables are drawn from NHSE information on Kingston practices that have
signed up to provide DES extended services. The detail provides a clear illustration of the
extended hours provided and the clinical professional providing the services:
18Monday - Tuesday - Tuesday -
Monday - Monday Monday Tuesday Tuesday
Extended Extended Extended
Extended Extended Extended Extended Extended
Hours Hours Hours
Practice Name Hours Hours 1 GP 2 GPs 3 GPs 1 Nurse 2 Nurses HCA Hours 1 GP 2 GPs 3 GPs 1 Nurse HCA Hours 1 GP 2 GPs 1 Nurse HCA Other Hours 1 GP 2 GPs 1 Nurse
Evening - Morning - Evening -
Morning - Morning - Evening - Morning - Evening -
start start start
start time end time end time end time end time
time time time
Canbury Medical Centre 07:00 08:00 1 GP HCA Advanced Nurse Practitioner
Brunswick Surgery 07:00 08:00 3 GPs 1 Nurse 18:30 19:00 1 GP
The Groves Medical Centre 07:00 08:00 1 GP 1 Nurse HCA 18:30 19:30 1 GP
Fairhill Medical Practice 18:30 20:00 2 GPs 18:30 20:00 2 GPs
Hook Surgery 18:30 19:00 2 GPs
Churchill Medical Centre 18:30 20:00 2 GPs 18:30 20:00 1 GP
St Alban's Medical Centre 07:30 08:00 2 GPs 2 Nurses HCA 07:30 08:00 2 GPs 1 Nurse
The Orchard Practice 07:30 08:00 1 GP 18:30 20:00 1 GP
Holmwood Corner Surgery 18:30 20:15 1 GP
Chessington Park Surgery
Roselawn Surgery 18:30 19:30 2 GPs 18:30 19:00 2 GPs
Berrylands Surgery 07:30 08:00 2 GPs
Red Lion Road Surgery (Mediventure Ltd) 06:30 07:30 1 GP 18:30 19:30 1 GP
Kingston Health Centre 07:00 08:00 1 GP 1 Nurse HCA
Langley Medical Practice 07:00 08:00 1 GP 1 Nurse 07:30 08:00 1 Nurse 18:30 20:00 1 GP
Sunray Surgery 07:30 08:00 1 GP HCA 18:30 20:00 1 GP 1 Nurse
Claremont Medical Centre 18:30 20:00 3 GPs 18:30 19:00 1 Nurse
The Village Surgery
Manor Drive Medical Centre 18:30 20:30 2 GPs 1 Nurse HCA
West Barnes Surgery 18:30 19:00 1 GP 1 Nurse 18:30 19:00 2 GPs
19Wednes Wednes
Wednes Wednes Thursday - Thursday - Friday - Friday - Saturday -
day - day - Thursday Thursday Friday Friday Saturday
day day Extended Extended Extended Extended Extended
Extended Extended Extended Extended Extended Extended Extended
Extended Extended Hours Hours Hours Hours Hours
Practice Name Hours 1 GP 2 GPs 1 Nurse 2 Nurses HCA Other Hours 1 GP 2 GPs 1 Nurse Hours 1 GP 2 GPs 1 Nurse HCA Hours 1 GP 2 GPs 1 Nurse Hours 1 GP 1 Nurse 2 Nurses HCA Hours 1 GP Hours 1 GP 1 Nurse
Hours Hours Morning - Evening - Morning - Evening - Morning -
Morning - Evening - Morning - Evening - Morning - Evening - Morning -
Morning - Evening - start start start start start
start start end time end time end time end time end time
end time end time time time time time time
time time
Canbury Medical Centre 07:00 08:00 2 GPs HCA
Brunswick Surgery 18:30 19:45 1 GP 07:30 08:00 1 GP
The Groves Medical Centre 07:30 08:00 1 Nurse 18:30 20:00 2 GPs 07:00 08:00 2 GPs
Fairhill Medical Practice 18:30 20:00 1 GP 18:30 20:00 1 GP 07:30 08:00 1 GP 08:00 11:30 1 GP
Hook Surgery 07:30 08:00 Nurse Practitioner 18:30 19:30 2 GPs
Churchill Medical Centre 18:30 20:00 1 GP 18:30 20:00 1 GP 18:30 20:00 1 GP
St Alban's Medical Centre 07:30 08:00 2 GPs 1 Nurse HCA 07:15 08:00 2 GPs 1 Nurse HCA 07:30 08:00 1 GP 1 Nurse
The Orchard Practice 18:30 20:00 1 GP 07:30 08:00 1 GP 18:30 20:00 1 GP
Holmwood Corner Surgery 18:30 20:15 1 GP 09:00 11:45 1 GP
Chessington Park Surgery 18:30 20:00 1 GP 1 Nurse 18:30 20:00 1 GP
Roselawn Surgery
Berrylands Surgery 07:00 08:00 1 GP
Red Lion Road Surgery (Mediventure Ltd) 18:30 19:00 1 GP
Kingston Health Centre 07:00 08:00 1 GP 1 Nurse HCA 07:00 08:00 1 GP 1 Nurse HCA 07:00 08:00 1 Nurse HCA
Langley Medical Practice 07:00 08:00 1 GP 1 Nurse
Sunray Surgery
Claremont Medical Centre 18:30 19:30 2 GPs 1 Nurse 08:30 11:30 1 GP
The Village Surgery 18:30 19:45 1 GP 18:30 19:45 1 GP
Manor Drive Medical Centre
West Barnes Surgery 07:30 08:00 1 GP 1 Nurse HCA 18:30 18:45 1 Nurse 18:30 19:00 1 GP 08:30 11:15 1 Nurse
208. Urgent Primary Care services
8.1 Urgent Treatment Centres
National guidance on Urgent Treatment Centres was published recently. It includes the
definition of an Urgent Treatment Centres (UTC) as:
“Urgent treatment centres (UTCs) are community and primary care facilities providing
access to urgent care for a local population. They encompass current Walk-in Centres, Minor
Injuries Units, GP-led Health Centres and all other similar facilities, including the majority of
those currently designated as “Type 3 and Type 4 A&E Departments”. Urgent treatment
centres will usually be led by general practitioners, and are ideally co-located with primary
care facilities, including GP extended hours / GP Access Hubs or Integrated Urgent Care
Clinical Assessment Services (formerly known as “GP out of hours” services)”.
The guidance sets out clear ‘minimum standards by which UTCs should operate. These
include:
• Urgent treatment centres should be open for at least 12 hours a day seven days a
week, including bank holidays. Typically this will be an 8-8 service
• Urgent treatment centres must include minor illness and injury in adults and children
of any age:
• including wound closure, removal of superficial foreign bodies and the
management of minor head and eye injuries.
• Access to investigations including:
• swabs, pregnancy tests and urine dipstick and culture. Near patient blood
testing, such as glucose, haemoglobin, d-dimer and electrolytes should be
available. Electrocardiograms (ECG) should be available, and in some urgent
treatment centres near-patient troponin testing could also be considered.
• Bedside diagnostics and plain x-ray facilities, particularly of the chest and limbs, are
desirable and considerably increase the assessment capability of an urgent
treatment centre, particularly where not co-located with A&E.
• Where these facilities are not available on site, clear access protocols should
be in place.
• Provide both pre-booked, same day and “walk-in” appointments
• Apply an effective and consistent approach to the primary prioritisation (triage) of
pre-booked appointments and “walk-in” appointments, and the allocation of pre-
booked routine and same day appointment slots (ratio)
• Ability to book an appointment in the urgent treatment centre by a single phone call
to NHS 111; patients should be encouraged to use NHS 111 as the primary route to
access an appointment at an urgent treatment centre.
• Patients who have a pre-booked appointment made by NHS 111 should be seen and
treated within 30 minutes of their appointment time
21• Patients who have a pre-booked appointment made by their GP should be seen and
treated within 30 minutes of their appointment time
• Patients who “walk-in” to an urgent treatment centre should be clinically assessed
within 15 minutes of arrival
• but should only be prioritised for treatment, over pre-booked appointments,
where this is clinically necessary.
• Following clinical assessment, walk in patients will be given an appointment slot,
which will not be more than two hours after the time of arrival.
• Be able to issue prescriptions, including repeat prescriptions and e-prescriptions
• Access to the electronic (up to date) patient care record
• Ability for other services (e.g. NHS 111) to electronically book appointments directly
Kingston Hospital is currently developing a UTC for the front end of Kingston A&E. The
current KHFT plans include the triage of patients, and could include redirection of patients
to the extended primary care services. The current contract with Kingston GP Chambers for
extended primary care services includes the provision for the extended primary care service
to be able to provide appointments for redirected patients. The contract for the Teddington
walk in centre that many Kingston residents use is being updated for 2018/19 to include the
ability to provide appointments for Richmond patients that are redirected.
8.2 GP Out of Hours Services
GP out of hours services are provided from 6.30pm to 8am on weekdays and all day at
weekends and on bank holidays. For Kingston residents this service is provided by a
partnership of Vocare and SELDOC. Sutton CCG manages this contract on behalf of Kingston
CCG and four of the other five SWL CCGs.
8.3 NHS 111
NHS 111 is a national telephone based service that helps callers identify the most
appropriate service for them to use. The intention is to integrate NHS 111 with the GP OOH
services and enable 111 to book directly into the extended primary care services/hubs,
enabling a seamless transfer for a patient calling the service.
229. Primary Care data
9.1 Numbers and ages of registered patients
As of 1st April 2017 there were 204,821 patients registered with a Kingston CCG practice. The number of patients registered per practice as of
1st April 2017 is set out below, by age band:
e
de m
Co Na
tic
e
tic
e
04 09 14 19 24 29 34 39 44 l 49 54 59 64 69 74 79 84 89 94
ac ac to to to to to to to to to + to
ta P to to to to to to to to to
P r P r 0 05 10 15 20 25 30 35 40 45
95 To W 50 55 60 65 70 75 80 85 90
H84053 Berrylands Surgery 263 247 211 159 231 298 304 361 302 315 273 255 216 215 177 124 102 71 36 8 4,168 4,013
H84015 Brunswick Surgery 554 501 410 345 362 530 729 756 648 619 545 419 331 286 215 151 114 81 38 22 7,656 6,725
H84010 Canbury Medical Centre 598 707 619 550 489 598 671 817 807 841 726 664 536 478 343 209 150 98 49 24 9,974 8,821
H84030 Central Surgery 788 783 687 564 533 789 1,033 1,135 1,113 980 903 696 580 580 490 361 272 198 102 44 12,631 11,588
H84050 Chessington Park Surgery 480 459 389 447 422 481 457 469 478 475 537 421 392 339 303 168 156 90 41 13 7,017 6,647
H84027 Churchill Medical Centre 1,471 1,460 1,044 743 922 1,426 1,795 1,881 1,800 1,449 1,121 905 680 600 531 331 226 149 63 25 18,622 16,137
H84619 Claremont Medical Centre 860 626 462 356 400 875 1,338 1,505 1,213 946 626 463 301 247 214 143 100 63 24 8 10,770 8,624
H84020 Fairhill Medical Practice 892 920 751 1,406 6,559 3,043 1,653 1,409 1,262 1,014 872 637 524 455 398 254 170 121 59 17 22,416 18,772
H84042 Holmwood Corner Surgery 818 824 709 688 730 851 992 1,078 1,049 968 883 682 549 546 415 323 277 198 83 30 12,693 11,192
H84025 Hook Surgery 518 509 414 355 401 491 604 582 539 534 446 385 313 274 252 178 139 90 42 15 7,081 6,693
H84058 Kingsdowne Surgery 172 168 179 205 209 280 309 296 283 272 278 225 242 228 188 143 109 64 29 11 3,890 3,786
H84062 Langley Medical Practice 511 458 378 316 381 567 642 678 635 623 556 455 346 336 301 195 159 105 29 12 7,683 7,091
H84635 Manor Drive Surgery 966 866 719 646 613 808 985 1,164 1,132 927 902 791 665 600 551 367 277 162 76 22 13,239 11,755
H84054 Red Lion Road Surgery 146 172 163 179 174 216 259 254 240 239 192 164 128 125 98 76 69 33 16 14 2,957 2,610
H84061 Kingston Health Centre 746 707 630 501 735 945 1,064 1,109 976 870 688 385 302 290 189 102 81 48 27 6 10,401 8,513
H84051 Roselawn 352 345 404 374 368 477 487 451 508 482 457 323 238 219 180 111 95 64 26 11 5,972 5,087
H84033 St Albans Medical Centre 410 508 498 434 313 341 345 480 560 582 615 504 387 362 311 218 166 103 54 16 7,207 6,624
H84618 Sunray Surgery 236 330 308 272 242 289 348 360 315 290 307 256 202 152 115 59 48 26 8 2 4,165 3,379
H84016 The Groves Medical Centre 780 1,071 1,093 962 742 912 929 1,185 1,204 1,254 1,166 972 784 704 529 415 315 267 149 52 15,485 13,916
H84034 The Orchard Practice 450 519 520 479 485 571 577 639 566 594 665 534 422 427 345 244 166 141 45 19 8,408 8,286
H84629 Village Surgery 217 296 304 288 307 478 462 385 442 413 344 301 221 170 167 102 56 34 8 1 4,996 4,090
H85055 West Barnes Surgery 331 424 409 431 436 473 475 600 566 582 546 509 415 376 292 222 142 93 48 20 7,390 6,247
KCCG 12,559 12,900 11,301 10,700 16,054 15,739 16,458 17,594 16,638 15,269 13,648 10,946 8,774 8,009 6,604 4,496 3,389 2,299 1,052 392 204,821 180,598
23The illustrations below allow you to see how the age bands by sex are spread across the Kingston registered population.
Age Band Male Female Male Female Kingston CCG Practice List Size Apr 2017
0 to 04 6,433 6,126 -6433 6,126
05 to 09 6,506 6,394 95+
-6506 6,394
10 to 14 5,657 5,644 90 to-5657
94 5,644
15 to 19 5,115 5,585 85 to-5115
89 5,585
20 to 24 6,965 9,089 80 to-6965
84 9,089
25 to 29 7,605 8,134 -7605
75 to 79 8,134
30 to 34 8,111 8,347 -8111
70 to 74 8,347
35 to 39 9,053 8,541 -9053
65 to 69 8,541
40 to 44 8,744 7,894 -8744 7,894
60 to 64
45 to 49 8,219 7,050 -8219 7,050
55 to 59
50 to 54 7,219 6,429 -7219 6,429
50 to 54
55 to 59 5,691 5,255 -5691 5,255
60 to 64 4,386 4,388 45 to-4386
49 4,388
65 to 69 3,946 4,063 40 to-3946
44 4,063
70 to 74 3,226 3,378 35 to-3226
39 3,378
75 to 79 2,050 2,446 30 to-2050
34 2,446
80 to 84 1,505 1,884 25 to-1505
29 1,884
85 to 89 881 1,418 -881
20 to 24 1,418
90 to 94 335 717 -335
15 to 19 717
95+ 102 290 -102
10 to 14 290
101,749 103,072 05 to 09
0 to 04
10000 8000 6000 4000 2000 0 2000 4000 6000 8000 10000
Male Female
249.2 Deprivation by practice
Kingston is a relatively affluent borough with deprivation scores well below the England
average. There is however variation across Kingston with all of the practices in the two
localities of Chessington and New Malden with a score over the CCG average.
259.3 Ethnicity by practice
The population in Kingston, like most London boroughs, is made up of a range of people from differing ethnic backgrounds. The practices in New Malden
have the greatest mix of ethnicity with Chessington the least.
269.4 Usage of GP appointments
In the last year in Kingston there have been over 800,000 GP appointments. That roughly equates to an average of 4 appointments per patient.
27% of these GP appointments could have been seen by a community pharmacist or nurse. Each and every GP in Kingston has more than 8
appointments a week missed. This does not include appointments where a patient has contacted the practice and cancelled, this is where a
patient simply does not turn up for a booked appointment. This adds to the pressure on appointments that could be avoided.
Appointments Not Attended Column Labels
Row Labels 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 Grand Total
2 - Appointment Cancelled By, Or On Behalf Of, The Patient 7,449 13,194 26,900 14,103 16,169 31,590 31,146 34,072 38,369 13,276 226,268
3 - Did Not Attend - No Advance Warning Given 15,799 18,251 20,786 18,688 19,333 16,915 19,098 20,061 20,863 6,031 175,825
4 - Appointment Cancelled Or Postponed By The Health Care Provider 4,421 14,140 27,123 13,984 12,634 30,832 37,187 41,563 45,317 15,376 242,577
Grand Total 27,669 45,585 74,809 46,775 48,136 79,337 87,431 95,696 104,549 34,683 644,670
In Kingston we have three extended primary care services that also offer GP appointments. The take-up of these appointments during the
week is high and the service is well used. However the weekday appointments also have a high level of ‘did not attend’ (averaging over 10%).
The weekend appointments have a low utilisation with only 50% of available appointments booked on a Saturday and even less on a Sunday.
Saturday and Sunday also have high levels of ‘did not attend’. Kingston CCG is currently working with the provider Kingston GP Chambers to
maximise the use of the service / redesign to better meet patient’s needs.
2728
10. General practice workforce
The general primary care workforce is made up of GPs (as partners and salaried members of the practice), Registrars, Nurses, Allied Health
Professionals, Medical Secretaries, Trainee Nurses, Health Care Assistants, and Practice Managers. General practices can also employ
therapists, pharmacists, pharmacy support staff, and physician associates amongst other roles.
10.1 Kingston primary care workforce as of March 2016:
GPs N= fte Male / female Over / under 55 years
Partners 65 54.57 42 Male 23 Female 19 over 55
Salaried GP 1 0.32 Male Over
Registrar (ST3/4) 3 1.81 1 Male 2 Female Under
GP Registrar 1 0.8 Male Under
Nursing staff N= fte Male / female Over / under 55 years
Advanced Nurse 12 8.43 All female 5 aged 55 and over
Practitioner
Health Care Assistants 22 14.41 All female 7 aged 55 and over
Nurse specialist 1 0.15 Female Over
Practice Nurse 49 27.23 All female 16 aged 55 and over
Admin/non-clinical N= fte Male / female Over / under 55 years
Practice Manager / 32 25.43 28 Female 4 Male 7 aged 55 and over
management
Receptionist 138 82.18 133 Female 5 Male 44 aged 55 and over
Medical Secretary 28 18.53 All female 14 aged 55 and over
Admin / estates / 30 21.41 28 Female 2 Male 12 ged 55 and over
ancillary
2910.2 Patient to GP Ratio
Patient to GP
Practice Name Patients GP FTE Note
Ratio
BERRYLANDS SURGERY 4139 4.67 887
BRUNSWICK SURGERY 7538 3.85 1956
CANBURY MEDICAL CENTRE 9937 4.89 2033
CENTRAL SURGERY 12561 0.00 0 Data not available
CHESSINGTON PARK SURGERY 6849 4.56 1502
CHURCHILL MEDICAL CENTRE 18440 11.37 1621
CLAREMONT MEDICAL CENTRE 10994 4.50 2444
FAIRHILL MEDICAL PRACTICE 21920 0.00 0 Data not available
GOSBURY HILL GP CLINIC 801 0.00 0 Data not available
GRAY'S MEDICAL CENTRE 766 0.00 0 Data not available
HOLMWOOD CORNER SURGERY 12522 7.09 1767
HOOK SURGERY 6813 3.61 1888
KINGSDOWNE SURGERY 3794 0.00 0 Data not available
KINGSTON HEALTH CENTRE 9842 0.00 0 Data not available
LANGLEY MEDICAL PRACTICE 7432 4.16 1787
MANOR DRIVE MEDICAL CENTRE 13066 5.73 2279
RED LION ROAD SURGERY 2925 0.00 0 Data not available
ROSELAWN 5867 3.56 1648
ST ALBANS MEDICAL CENTRE 7149 4.27 1676
SUNRAY SURGERY 3926 2.53 1550
THE GROVES MEDICAL CENTRE 15544 0.00 0 Data not available
THE ORCHARD PRACTICE 8080 4.53 1782
VILLAGE SURGERY 4848 2.93 1653
WEST BARNES SURGERY 7397 3.12 2371
203150 75.38 2695
3010.3 Total Health Care professionals per practice FTE
Practice Name GPS Other Doctors Senior Partners Provisional Partners Nurses Dental Practitioners Total Health Professionals
BERRYLANDS SURGERY 4.67 4.67 0.89 2.22 1.23 0 13.68
BRUNSWICK SURGERY 3.85 3.85 1 2.43 1.61 0 12.74
CANBURY MEDICAL CENTRE 4.89 4.89 0.89 1.56 3.03 0.91 16.17
CENTRAL SURGERY 0 0 0 0 4.27 1.77 6.04
CHESSINGTON PARK SURGERY 4.56 4.56 1.07 1.07 1.68 0.51 13.45
CHURCHILL MEDICAL CENTRE 11.37 11.37 0.87 1.13 3.25 2.17 30.16
CLAREMONT MEDICAL CENTRE 4.5 4.5 0.67 2.13 1.08 0 12.88
FAIRHILL MEDICAL PRACTICE 0 0 0 0 1.65 1 2.65
GOSBURY HILL GP CLINIC 0 0 0 0 0 0 0
GRAY'S MEDICAL CENTRE 0 0 0 0 0 0 0
HOLMWOOD CORNER SURGERY 7.09 7.09 0.7 5.8 3.03 1.4 25.11
HOOK SURGERY 3.61 3.61 1.09 1.09 1.37 0.8 11.57
KINGSDOWNE SURGERY 0 0 0 0 0.48 0.32 0.8
KINGSTON HEALTH CENTRE 0 0 0 0 1.27 1.81 3.08
LANGLEY MEDICAL PRACTICE 4.16 4.16 0.53 2.13 1.29 0 12.27
MANOR DRIVE MEDICAL CENTRE 5.73 5.73 1.2 2.4 1.71 0.53 17.3
RED LION ROAD SURGERY 0 0 0 0 0.32 0 0.32
ROSELAWN 3.56 3.56 1 2 1.01 0.83 11.96
ST ALBANS MEDICAL CENTRE 4.27 4.27 0.67 2.13 1.76 1 14.1
SUNRAY SURGERY 2.53 2.4 0.8 1.6 0.45 0 7.78
THE GROVES MEDICAL CENTRE 0 0 0 0 4.81 3.55 8.36
THE ORCHARD PRACTICE 4.53 4.53 0.13 0.88 1 1.21 12.28
VILLAGE SURGERY 2.93 2.93 1.2 1.2 0.96 0 9.22
WEST BARNES SURGERY 3.12 3.12 0.53 2.59 0.91 0.93 11.2
0
75.37 75.24 13.24 32.36 38.17 18.74 253.12
3110.4 GPs by Age Band
GPs GPs GPs GPs 60 And
GPs Between GPs Between GPs Between GPs Between GPs Between GPs Between 65 GPs 70 and
UNDER Between 30 Between 35 Above
40 AND 44 45 AND 49 50 AND 54 55 AND 59 60 AND 64 AND 69 Above
Practice Name 30 AND 34 AND 39 (overall)
BERRYLANDS SURGERY 0 1 1 2 2 0 0 0 0 0 0
BRUNSWICK SURGERY 0 0 0 5 0 0 0 0 0 0 0
CANBURY MEDICAL CENTRE 0 2 1 2 1 0 0 0 0 0 0
CENTRAL SURGERY 0 0 0 0 0 0 0 0 0 0 0
CHESSINGTON PARK SURGERY 0 0 1 2 1 1 1 0 0 0 0
CHURCHILL MEDICAL CENTRE 0 3 5 3 1 3 1 0 0 0 0
CLAREMONT MEDICAL CENTRE 0 1 1 2 3 0 0 0 1 0 1
FAIRHILL MEDICAL PRACTICE 0 0 0 0 0 0 0 0 0 0 0
GOSBURY HILL GP CLINIC 0 0 0 0 0 0 0 0 0 0 0
GRAY'S MEDICAL CENTRE 0 0 0 0 0 0 0 0 0 0 0
HOLMWOOD CORNER SURGERY 0 3 1 1 1 0 2 0 0 0 0
HOOK SURGERY 0 0 1 2 1 0 1 0 0 0 0
KINGSDOWNE SURGERY 0 0 0 0 0 0 0 0 0 0 0
KINGSTON HEALTH CENTRE 0 0 0 0 0 0 0 0 0 0 0
LANGLEY MEDICAL PRACTICE 0 2 1 1 0 1 0 0 0 0 0
MANOR DRIVE MEDICAL CENTRE 0 0 3 0 1 1 0 0 0 0 0
RED LION ROAD SURGERY 0 0 0 0 0 0 0 0 0 0 0
ROSELAWN 0 0 1 0 1 0 0 1 1 0 2
ST ALBANS MEDICAL CENTRE 1 0 0 0 0 0 2 0 1 1 2
SUNRAY SURGERY 0 0 2 1 0 1 0 0 1 0 1
THE GROVES MEDICAL CENTRE 0 0 0 0 0 0 0 0 0 0 0
THE ORCHARD PRACTICE 0 2 2 1 1 2 1 0 0 0 0
VILLAGE SURGERY 0 0 0 0 1 0 0 1 0 1 2
WEST BARNES SURGERY 0 0 1 0 0 3 0 0 0 0 0
1 14 21 22 14 12 8 2 4 2 8
3211. The GP Patient Survey
The GP Patient Survey is an England wide survey commissioned by NHSE provided by ipsos
MORI. The information below is taken from the July 2017 Patient Survey.
The results published are based on 2,491 responses to the 7,112 questionnaires were sent
out; a response rate of 35%. ipsos MORI acknowledge that the survey has limitations:
Sample sizes at practice level are relatively small
The survey does not include qualitative data which limits the detail provided by the
results
The data are provided once a year rather than in real time
However Kingston CCG through its Primary Care Commissioning Committee and Primary
Care Patient Forum recognises the feedback on telephone access to practices and has
collaborated with Kingston GP Chambers to secure investment to roll out a new, pan
practice integrated telephone system that we believe will address the telephony issues
currently being experience by Kingston patients.
11.1 Overall experience of GP surgeries
Kingston practices score 83% ‘Good’ against a national average of 85%. The ‘Good’
experience across practices ranged from 73% to 87%.
Results from the GP Patient Survey on overall experience are illustrated below:
Very good
4%
12%
Fairly good
38%
Neither good nor poor
Fairly poor
45% Very poor
3311.2 Patient experience of telephone access
Kingston practices achieve a score of 63% on the ease of getting through to the surgery on
the phone, against a national average of 68%.
Results from the GP Patient Survey on telephone access are illustrated below:
4% Very easy
11% 16%
Fairly easy
Not very easy
22%
Not at all easy
Haven't tried
47%
Kingston CCG in partnership with Kingston GP Chambers submitted a bid to the Estates &
Technology Transformation Fund (ETTF) to provide investment to introduce a new,
integrated across practices telephony system. Kingston GP Chambers is in the process of
rolling VOIP out across the Kingston practices.
11.3 Success in getting an appointment
Kingston practices score 85% ‘Yes’ against a national average of 84% on the question ‘Last
time you wanted to see or speak to a GP or nurse from your GP surgery, were you able to
get an appointment to see or speak to someone?.
Results from the GP Patient Survey on getting an appointment are illustrated below:
34Yes
4%
11%
Yes, but I had to call
back closer to or on the
17%
day
No
68%
Can't remember
11.4 Waiting time at the GP surgery
Kingston practices score 61% ‘Don’t wait too long’ against a national average of 58% on the
question ‘How do you feel about how long you normally have to wait to be seen?
Results from the GP Patient Survey on waiting times are illustrated below:
8% I don't normally have to wait
7% too long
I have to wait a bit too long
I have to wait far too long
25%
61%
No opinion/doesn't apply
3511.5 Patient perception of care
Kingston practices score 95% on the question ‘Did you have confidence and trust in
the GP you saw or spoke to?’ in line with the national average of 95%.
Kingston practices score 97% on the question ‘Did you have confidence and trust in
the nurse you saw or spoke to?’ in line with the national average of 97%.
11.6 Patient satisfaction with opening hours
Kingston practices score 75% on the question ‘How satisfied are you with the hours that
your GP surgery is open?’ against a national average of 76%.
Results from the GP Patient Survey on opening hours are illustrated below:
Very satisfied
3%4%
7%
Fairly satisfied
34%
11%
Neither satisfied nor
dissatisfied
Fairly dissatisfied
41% Very dissatisfied
I'm not sure when my GP
surgery is open
3612. Care Quality Commission (CQC) ratings
The CQC inspects and regulates health and social care services. The role of the CQC is to regulate
through registration and continuously monitor the quality of the services provided through
inspections. The inspection of a GP service covers five key areas:
Safe Is the patient protected from abuse and avoidable harm
Effective Does the care, treatment and support achieve good outcomes, helping patients to
maintain quality of life and is based on the best available evidence
Caring Do the staff involve and treat patients with compassion, kindness, dignity and
respect
Responsive Are services organised so that they meet patients’ needs
Well led Is the leadership, management and governance of the organisation making sure
that it is providing high-quality care that's based around patient individual needs,
that it encourages learning and innovation, and that it promotes an open and fair
culture
A summary of the CQC findings for Kingston practices is below:
• Overall quality of care in Kingston is good
• All of the 22 practices in Kingston have been inspected and had reports
Practices that have received ‘requires improvement’ or ‘inadequate’ ratings work towards
addressing the issues within a set timeframe. This is overseen by KCCG Primary Care Quality &
Development Group (PCQDG) which reports to the Primary Care Commissioning Committee.
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