Archived: Skegby Family Medical Centre

Updated 31 August 2017

Skegby Family Medical Centre provides primary medical services to approximately 8,997 patients residing in Skegby, Stanton-Hill, Teversal and parts of Sutton-in Ashfield and Huthwaite. The practice is accessible to people using wheelchairs and those with other disabilities and has car parking facilities for both patients and staff.

The practice provides services to patients who reside in eight care and residential homes in Sutton-in Ashfield and surrounding areas.

On the 1 December 2015, two established local practices ‘Woodside Surgery’ and ‘Healdswood Surgery’ merged to become Skegby Family Medical Centre which now provides services from the former Healdswood Surgery premises.

The practice is located within the area covered by NHS Mansfield and Ashfield Clinical Commissioning Group (CCG). The practice has a General Medical Services (GMS) contract. It is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning; maternity and midwifery services and surgical procedures.

At the time of our inspection, the practice employed five GP partners (three male, 2 female), three advanced nurse practitioners, one practice nurse, three health care assistants, four administrators, eight receptionists, one apprentice in administration/reception duties and two housekeepers. All staff were supported by a practice manager.

Skegby Family Medical Centre is open from 8am until 6.30pm Monday to Friday.

The practice has a higher than average number of patients between the ages of 50 and 54 years of age and 60% of patients have a long standing health condition compared to the national average of 56%.

The practice provides on-line services for patients such as to book routine appointments, ordering repeat prescriptions and access to patient summary care record.

Skegby Family Medical Centre is a teaching practice for undergraduate medical and nursing students from the Nottingham University Medical School.

When the surgery is closed GP out-of-hours services are provided by Primary Care 24 located at Kings Mill Hospital, Nottingham which can be contacted via NHS111.

Updated 31 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Skegby Family Medical Centre on 22 June 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 a system in place for reporting and recording significant events.

• The practice had clearly defined and embedded systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.

• 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 the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review process and methods for identification of carers and the system for recording this. To enable support and advice to be offered to those that require it.

• Continue to address the issues highlighted in the national GP patient survey in order to improve patient satisfaction, including in respect of satisfaction on access to appointments and telephone access.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 August 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• All these patients had a named GP and there was a system to recall patients for 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 multi-disciplinary package of care.

Updated 31 August 2017

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

• We found there were systems 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 accident and emergency (A&E) attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

• Weekly midwifery led clinics were provided in the practice.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

• Childhood immunisations were carried out in line with the national childhood vaccination programme. Uptake rates for the vaccines given were higher than the national average. For example, rates for the vaccines given to under two year olds ranged from 95% to 96% compared to the national average of 90%.

Updated 31 August 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 31 August 2017

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

• The needs of these populations 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 31 August 2017

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

• The practice carried out advance care planning for patients living with dementia.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

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

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

Updated 31 August 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 and those with a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.