Medically Limited Also known as The Banks Surgery

Updated 26 April 2017

Medically Limited (The Banks Surgery) is situated in Sileby, a village north west of Leicester. There is a local population of about 8,500 which will increase as up to 1000 new homes are built over the next five years. Sileby is an area with some pockets of social deprivation alongside private housing. The practice has 5358 patients.

The practice occupies single storey premises built in 1979 and extended in 1984. It has a General Medical Services contract (GMS) to deliver primary care services to local communities.

The practice has two long term locum male GPs who each work nine sessions a week. There are two nurse practitioners and two health care assistants who are all female. There is also a business/practice manager, assistant practice manager and other support staff.

The practice is open between 8.30am and 6.00 pm Monday to Friday with the exception of Thursday when it closes at 1.00pm. On this afternoon and between 8.00 and 8.30am and 6.00 and 6.30pm the practice has a contract with Primecare whose telephone number is provided by the answerphone message and on the practice’s website.

Out of hours services are provided by DHU (Derbyshire Health United).

Updated 26 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Medically Ltd. (The Banks Surgery) on 20 July 2016. 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and generally well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients appreciated being able to speak with a GP and where necessary have an appointment on the same day or pre-booking appointments with a preferred GP
• Urgent appointments were made available for vulnerable patients and unwell children even where the sessions were fully booked.
• The practice had adequate facilities and equipment.
• 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 and complied with the requirements of the duty of candour.

However there was an area where the provider should make an improvement:

• The provider should review their response to the results of the National Patient Survey to identify additional actions to drive improvement particularly in the area of GP interactions with patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 April 2017

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's performance for diabetes management was similar to or slightly higher than national averages, for example, 90% of diabetic patients in whom the last blood pressure reading was 140/80mmHg or less compared to the local average of 77% and national average of 78%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and 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 multidisciplinary package of care.

• The practice’s web site included a section on long term conditions with information and links to factsheets and resources.

Updated 26 April 2017

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 relatively high 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, and we saw evidence to confirm this.

• Data showed 82% of eligible women had received a cervical screening test compared with the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice offered 24 hour and 6 week baby checks.

• We saw examples of joint working with midwives, health visitors and school nurses.

Updated 26 April 2017

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

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

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

• The practice had identified those older patients at risk of hospital admission and had developed a care plan template which identified key health problems and their ongoing management and included information, for example, about resuscitation choices. Special notes were included on records for out of hours services to avoid unnecessary or inappropriate hospital admissions.

Updated 26 April 2017

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 reflected the needs for this age group.

• The practice offered a telephone consultation with a GP or nurse practitioner to every patient who telephoned. Call backs were made when needed and appointments made for those who needed to be seen. The practice monitored this and could demonstrate that 95% of call-backs were made within an hour unless a later time had been requested, for example, after collecting children from school.

Updated 26 April 2017

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

• 94% of patients living with dementia had a face-to-face care review in the previous 12 months, compared with the national average of 84%.

• 100% of patients with severe mental health problems had a comprehensive agreed care plan documented in their records compared with the national average of 89%.

• 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 and where appropriate their carers 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. For example, they were routinely offered longer appointments.

Updated 26 April 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 carers, people with a learning disability and those with alcohol or substance misuse problems.

• The practice offered longer appointments for patients with a learning disability including those living in local college supported accommodation. The practice worked closely with the management of this accommodation to ensure students received annual health checks.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice had identified that 55 or 1.3% of its patients aged over 18 had caring responsibilities and offered health checks and information about local support services. There was also information available in the waiting area.

• 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.