Meon Medical Centre

Updated 18 October 2017

Meon Medical Centre is located in the village of Lower Quinton, near Stratford-Upon-Avon in Warwickshire. It is close to the borders with two other counties – Worcestershire and Gloucestershire. It has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice building is a modern, purpose built facility which

Offers dispensing services to those patients on the practice list who live more than one mile (1.6km) from a pharmacy.

At the time of our inspection there were 4,377 patients registered with the practice and this was increasing (for example, 3,000 were registered in 2008). A total of 8% (346) patients are aged over 75.

The practice has one partner GP (female), three salaried GPs (two female and one male), two practice nurses and a healthcare assistant. They are supported by a practice manager (who is also a business partner) and administrative and reception staff. A further ten staff members were employed in the dispensary, this included the manager, six qualified dispensers and three dispensary assistants.

The practice is open from 8.30am to 6.30pm during the week (5.30pm on Fridays) and appointments are available throughout these times. Extended hours appointments are available on Mondays until 8pm. When the practice is closed, patients can access care from 8am to 8.30am and from 5.30pm to 6.30pm on Fridays by their call being diverted to a specialist call handling company who signpost them to other local practices or care providers. Outside of these hours care is provided by Care UK through NHS 111. The practice has a recorded message on its telephone system to advise patients. This information is also available on the practice’s website and in the literature it produces.

There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice.

Home visits are available to patients who cannot reach the practice and the practice also has a good working relationship with the local shared taxi service and makes arrangements for transport when necessary.

The practice treats patients of all ages and provides a full range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease. Other appointments are available for blood tests (every morning), family planning and smoking cessation. It is also a member of the local GP federation, the South Warwickshire Federation. This comprises 34 GP practices. The practice also provides services to a local care home which includes a 30 bed dementia unit.

Updated 18 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Meon Medical Centre on 8 August 2017. Overall the practice is rated as good.

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

• Patients’ needs were assessed and care was delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Services were planned and delivered to meet the needs of the practice population, for example, the practice considered the care and social needs of its patients aged over 75 and had introduced initiatives to help meet these. For example, An over 75s co-ordinator worked with the practice team to identify elderly patients who were lonely or socially isolated. Those identified were offered support.
• Patients told us they were treated with dignity, respect and compassion. Patients were involved in decisions about their care and treatment. Patients also said GPs gave them enough time, were respectful and gave them all the information they needed. Results from some areas of the National GP Patient Survey published in July 2017 showed the practice was performing substantially above local and national averages.
• Urgent same day patient appointments were available when needed. All patients we spoke with and those who completed comment cards before our inspection said they were always able to obtain same day appointments.
• Information about how to complain was available and easy to understand. The practice received very few complaints from patients. Those they received were reviewed to ensure lessons learned were not repeated.
• Risks to patients were assessed and well managed both within the practice and its associated dispensary.
• There were clearly defined processes and procedures to ensure patients were safe and an effective system in place for reporting and recording significant events and were fully reviewed at every staff meeting.
• In addition to formal planned meetings, staff met briefly on a daily basis to identify and find solutions for the challenges and concerns of each day.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 18 October 2017

The practice is rated as good for the care of people with long-term conditions.

• Patients had a named GP and a review at least every 12 months to monitor their condition and ensure they received correct medicines. The frequency of the review depended on the severity of the patient’s condition and the complexity of their needs.
• The practice identified patients who were at risk of developing diabetes and offered them appropriate lifestyle advice.
• Nursing staff had received appropriate training in chronic disease management, for example, asthma and diabetes.
• The practice achieved a 100% vaccination record for diabetes patients during 2015-2016.

• Longer appointments and home visits were available when needed. 

Updated 18 October 2017

The practice is rated as good for the care of families, children and young people.

• Systems were in place to identify children and young people who might be at risk. As the practice was located at borders of Warwickshire, Worcestershire and Gloucestershire, relevant contact details were readily available for appropriate agencies in all three counties.
• A total of 81% of eligible patients had received cervical screening in the last 12 months. This was in line with the national average of 81%.
• The practice provided a ‘one-stop shop’ for baby checks by co-ordinating practice nurse appointments for vaccinations with the 6-8 week checks.
• There were appointments outside of school hours (the last two appointments each day were specifically reserved) and the practice building was suitable for children and babies.
• Outcomes for areas such as child vaccinations were in line with or above average for the Clinical Commissioning Group (CCG).
• We saw positive examples of joint working with midwives who were available at the practice weekly. The practice also worked closely with the local health visiting team who held clinics at practice twice every month.
• A full range of family planning services was available.

• The practice had a dedicated teenage page ‘Teenage Healthfreaks’ on its website which provided relevant information in an easily accessible and age appropriate way.

Updated 18 October 2017

The practice is rated as good for the care of older people.

• Older patients were given personalised care which reflected their needs. For example, all patients aged over 75 were offered a holistic well person check and an information booklet.
• An over 75s Patient Participation Group (PPG) ran at the practice. In addition to providing input into how the practice ran, the group also carried out art and craft activities and other patients of the same age group were welcomed.
• An over 75s co-ordinator worked with the practice team to identify elderly patients who were lonely or socially isolated. Those identified were offered support.
• Regular events were organised by the practice for over 75s. For example, over 300 patients aged over 75 recently attended a party organised by the practice.
• Over the last 12 months all patients aged 75 and over had been invited for a health check. This included blood tests, fracture assessment, frailty assessment, and checks for depression and dementia. From those checks, the practice identified patients who needed further investigation and referred them appropriately. These checks were also incorporated into the checks provided for new patients if they were aged 75 or over.
• The practice reported a 20% reduction in demand for GP appointments among patients over 75 who had previously received an over75s assessment.
• The weekly GPs ward round of a local nursing home was carried out alongside a consultant psychogeriatrician (a consultant who deals with poor mental health in older people). This had been initiated by the practice to provide an improved service for the home which had a large number of residents with dementia and had enabled mental health needs to be more clearly identified and quickly addressed.
• Home visits were available to patients who could not reach the practice.
• Nationally reported data showed that outcomes for patients were average for conditions commonly found in older people.
• The practice’s care for over 75s had been recognised at regional and national level

Updated 18 October 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice ensured it provided services to meet the needs of the working age population. For example, extended hours appointments were available on Monday evenings.
• Telephone consultations were available for patients who were unable to reach the practice during the day and the practice had recently increased the number of appointments that could be booked on-line.
• During flu vaccination season, the practice offered evening flu clinics to accommodate patients who worked during the day.
• A full range of services appropriate to this age group was offered, including travel vaccinations.

• The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening. For bowel cancer 63% of eligible patients were tested against the national average of 58% and for breast cancer screening 75% were tested against the national average of 73%.

Updated 18 October 2017

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%.
• Performance for mental health related indicators was above the local and national average, at 96% with an exception rate of 4%. This was above the CCG average of 93% with an exception rate of 8% and above the national average of 89% with an exception rate of 10%.
• The practice worked with multi-disciplinary teams to provide appropriate care for patients with poor mental health. This included patients with dementia.
• Patients were signposted to appropriate local and national support groups.

• Staff demonstrated a good working knowledge of how to support patients with mental health needs and dementia.

Updated 18 October 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• There was a register of vulnerable patients including those with a learning disability.
• Longer appointments were available when needed.
• The practice worked with other health care professionals to provide care to vulnerable patients, for example, there were two dedicated health visitors and district nursing team.
• Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 2% of the practice list as carers.