Archived: Dr Robert Bailey Also known as Minster Medical Practice

Updated 7 July 2017

Dr Robert Bailey’s practice, Minster Medical Practice, is situated within the Thomas Walker Medical Centre in Peterborough, Cambridgeshire. It is contracted to provide general medical services to approximately 4,200 registered patients.

According to information taken from Public Health England, the practice population has a smaller percentage of patients aged 30 to 44 and below 14 in comparison to the national average for practices in England. The practice is in an urban area and compared to national averages has a higher level of deprivation for patients aged over 65.

Income deprivation levels affecting older people and children are higher than the national average. The practice clinical team consists of one lead GP, one regular longstanding locum GP, one nurse practitioner, two practice nurses and two healthcare assistants. They are supported by a practice manager, a secretary and five receptionists / administrators (two of whom also work as health care assistants).

The practice is open Monday to Friday from 8.15am to 6.30pm and offers appointments from 8.30am to 5.45pm excluding lunch hours. Out-of-hours care is provided by Herts Urgent Care via the NHS 111 service and by a collaboration of local practices offering GP care between 8am and 8pm during weekends. Appointments with both GPs and nurses can be booked up to eight weeks in advance.

Updated 7 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Robert Bailey on 18 November 2016. The overall rating for the practice was good, with requires improvement for providing effective services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Dr Robert Bailey on our website at www.cqc.org.uk.

We undertook a desk-based focused inspection to confirm whether the practice had acted upon the areas for improvement identified in our previous inspection on 18 November 2016. This report only covers our findings in relation to those areas.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had implemented a new strategy to ensure that outcomes within indicators of the Quality and Outcomes Framework were improved upon from previous years. The practice had achieved below average scores in comparison to local and national averages between 2013 and 2016. The practice sent us details of their most recent, unverified, performance for 2016/2017, which evidenced that significant improvements had been made.
• The practice business continuity plan had been updated with information relevant for its purpose, and copies of it were now kept off site.
• Amendments had been made to the practice complaints policy to ensure that verbal complaints were recorded consistently.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 December 2016

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.
• The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2015/2016 showed that performance for diabetes related indicators was 71%, which was below the local average of 90.5% and national average of 90%. Exception reporting for diabetes related indicators was considerably lower than the local and national averages (exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).

• Longer appointments and home visits were available when needed.
• Patients with complex needs had a named GP and a structured annual review to check their health and medicines needs were being met. There was a recall system in place to ensure that patients were invited and attended annual reviews.
• For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 December 2016

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 in line with local and national averages 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.
• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 74%, which was in line with the local average of 72% and the national average of 74%. Exception reporting for this indicator was 6% which was in line with the local average of 8% and the national average of 6%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• All staff were trained to child safeguarding level three.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 19 December 2016

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

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice contacted patients after their discharge from hospital to address any concerns and assess if the patient needed GP involvement at that time.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure, were generally below local and national averages during 2015/16 but the practice had implemented a new strategy and lead person, to address this and considerable improvements had been made during 2016 to date. The practice informed us they were on target to achieve outcomes in line with national and local averages.

Updated 19 December 2016

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.
• Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years.

Updated 19 December 2016

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

• The practice had 49 registered patients with dementia, of which 45 required an annual review, of these, 43 had received an annual review in the last 12 months.
• The practice had 46 registered patients experiencing poor mental health, of which 36 required an annual review, of these, 32 had received an annual review in the last 12 months.
• 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 19 December 2016

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 those with a learning disability. The practice had 11 registered patients with a learning disability of which eight had received a review in the last 12 months and three were due one. The practice informed us that invites were sent and that they liaised with the local learning disabilities services if they had any specific concerns.
• 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.
• Patients who were carers were proactively identified and signposted to local carers’ groups. The practice had 51 patients registered as carers (approximately1.2% of patient list).
• 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.