Archived: Dr Yella Sambasivarao Also known as Mayfield Medical Centre

Updated 10 July 2018

Mayfield Medical Centre provides primary medical services to approximately 3,199 patients in the Hyson Green area of Nottingham. The registered address with Care Quality Commission (CQC) is 12 Terrace Street, Hyson Green, Nottingham NG7 6ER.

The practice provides primary care medical services via a General Medical Services (PMS) contract commissioned by NHS England and Nottingham City Clinical Commissioning Group (CCG). It is located within Greenfields Medical Centre, whose premises are co-owned by the two GP practices who operate from the building.

Dr Yella Sambasivarao is a single handed male GP who manages the practice. Dr Sambasivarao is the Registered Manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

He is supported by three long term locum GPs (two male and one female) providing a total of four sessions a week. The staff team includes five administrative staff, a practice manager and a business manager. The senior receptionist has a dual role as a phlebotomist. At the time of our inspection, the provider employed two bank nurses providing four sessions a week whilst they were recruiting for a permanent position. Cleaning staff were employed directly by Greenfields (the provider co-owned the building called Greenfields with neighbouring practice) and they were managed by the business manager

Public Health England data shows the area served by the practice is in the most deprived decile, meaning they have high deprivation levels which are above the practice average across England. There are 44% of people in the practice area who are from BME groups. It has a higher proportion of people aged under 18 years old compared to the CCG and national averages.

The practice is open from 8am to 6:30pm on Monday to Friday. Extended opening hours are offered on Monday evenings from 6.30pm to 8pm. GP consultation times start at 8.30am until 5.50pm. The practice has opted out of providing out-of-hours services to their own patients. When the practice is closed, patients are advised to dial NHS 111 and they will be put through to the out of hours service which is provided by Nottingham Emergency Medical Services (NEMS) provider.

Updated 10 July 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Requires improvement overall. (Previous inspection 26/08/2015 – Good)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Requires improvement

People with long-term conditions – Requires improvement

Families, children and young people – Requires improvement

Working age people (including those recently retired and students – Requires improvement

People whose circumstances may make them vulnerable – Requires improvement

People experiencing poor mental health (including people with dementia) – Requires improvement

We carried out an announced inspection at Mayfield Medical Centre on 23 March 2018 as part of our inspection programme.

At this inspection we found:

• Some risks to patients were assessed and well managed. When incidents did happen, the practice learned from them and improved their processes.
• However, patients were potentially at risk of harm because systems relating to emergency medicines and equipment were not fully effective to keep patients safe.
• Recruitment checks were not managed effectively in line with the practice policy and regulations. Health and safety assessments did not fully minimise risks.
• Arrangements relating to health and safety were not managed effectively.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Data showed patient outcomes were mostly in line with or above the local and national averages for most indicators. However, cancer screening rates were below local and national averages.
• Staff involved and treated patients with compassion, kindness, dignity and respect. Feedback from patients we spoke with during our inspection was highly positive about the caring approach of all staff.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice understood the needs of its population and tailored services in response to those needs.
• The practice had a number of policies and procedures to govern activity, but some of these needed to be reviewed to ensure they contained up to date information.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Consider annual reviews of significant events to facilitate trend analysis of the issues recorded.
• Establish a system for logging safety alerts received to assure themselves how these have been acted on.
• Strengthen the system for managing staff training to ensure all training considered mandatory is undertaken and up to date.
• Update the complaints leaflet for patients with up to date signposting information.
• Strengthen ways in which the service seeks and acts on patients’ views in regards to the care and treatment provided through engaging with more patient participation group members.
• Review processes in place to improve uptake rates for national screening programmes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 July 2018

Updated 10 July 2018

Updated 10 July 2018

Updated 10 July 2018

Updated 10 July 2018

Updated 10 July 2018