Archived: Highfields Medical Centre

Updated 7 January 2016

Highfields Medical Centre is a two partnership practice in a purpose built building, the Merlyn Vaz Centre that is shared with another practice. The practice list size is approximately 7200 patients. The practice does have a branch surgery however at the time of our registration this was registered with the CQC as a separate location and therefore we were unable to inspect at this visit however this had been rectified since the inspection.

The site has ample car parking and pedestrian access. Other services on the site include council services, dentists, a walk in GP practice, district nurses, health visitors and community mental health services.

The practice has two GP partners both male and there is also one female salaried GP working at the practice. The practice employs a business manager, a female nurse prescriber, who is also the nurse manager, a practice nurse and one health care assistant. Administration and reception duties are provided by one senior receptionist and six reception staff. The practice is a training practice for fullyqualified doctors who are learning to become GP’s. At the time of the inspection the practice had two doctors that were training.

The two partners have taken over full operational running of the practice in the last year and have recruited new clinical and non clinical staff including a new business manager. Since they have taken over new systems of working have being implemented and the environment has changed as the practice moved into the purpose built health centre.

The practice provides GP services under a (GMS) General Medical Services contract.

The practice has 91% of its patients under 65 years old. The patients are 99% South Asian in origin which brings cultural issues in relation to managing patients in relation to conditions such as mental health and identification of carers.

The surgery is open from 8am until 8pm Monday to Thursday and 8am until 6.30pm on Friday. Appointments are available from these times and include telephone consultations and telephone triage. Appointments can be booked on the day or up to two weeks in advance. The practice has made an application to commence Saturday morning appointments in the near future.

The practice lies within the NHS Leicester City Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

The practice had not previously been inspected by the Care Quality Commission.

Updated 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Highfields Medical Centre on 14 October 2015.

Overall the practice is rated as good.

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

• Urgent appointments were available the same day.
• The practice had good facilities including disabled access and was found to be clean and tidy.
• Information about services and how to complain was available.
• Patients said they felt the practice offered an excellent service and staff were friendly and caring and treated them with dignity and respect
• There were systems in place to reduce risks to patient safety for example, infection control procedures.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles.
• Recruitment checks were carried out and the appropriate recruitment checks had been undertaken prior to employment.
• The practice had a comprehensive business continuity plan in place for major incidents such as power failure or building damage.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

• Complaints were managed and dealt with effectively.

However there were areas where the provider should make improvements.

Importantly the provider should:

• Make available training of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Ensure action plan for Learning Disability reviews is monitored through the practice meetings.
• Continuously monitor feedback to evidence improvement in relation to appointment satisfaction.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 January 2016

The practice is rated as good for the care of people with long-term conditions. GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All patients had a named GP and a structured annual review to check that their health and medication needs were being met. Patients were encouraged to manage their conditions and were referred to health education and other services such as smoking cessation. Special notes were used on the patient record enabling out of hours providers to be informed of any special information they may need in relation to these patients outside normal surgery hours.

Updated 7 January 2016

The practice is rated 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. The practice met with health visitors, midwives and school nurses on a six weekly basis to discuss any safeguarding issues. Communication was also through the clinical system with GPS, nurse and health visitor. Immunisation rates were high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 7 January 2016

The practice is rated good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.  The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits, if necessary as well as same day appointments if needed. Every patient had a named GP. The practice had contact with district nurses and participated in monthly meetings with other healthcare professionals to discuss any concerns.

Updated 7 January 2016

The practice is rated good for the care of working-age people (including those recently retired and students). The practice surgery had extended appointments Monday to Thursday to 8pm and patients were always able to get an appointment on the day in an emergency. The practice had applied for Saturday morning opening for the future. The practice also offered telephone consultations with a clinician if requested and also offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 7 January 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). 80% of people experiencing poor mental health or dementia had received an annual review. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health. The practice had worked on mental health management and had provided an awareness day for their patients, with clinical experts involved, highlighting south Asian care organisations that could provide support. The practice had also had a staff training session in relation to loneliness which also included non-clinical staff so that they were also aware of signs to look for and could offer support and signposting.

It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 7 January 2016

The practice is rated good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had been identified that health checks had not been provided for this patient group and an action plan had been put into place to address this with one of the partners taking the lead for this. Longer appointments were available for people with a learning disability. Staff had been trained 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.