• Doctor
  • GP practice

The Lander Medical Practice

Overall: Good read more about inspection ratings

Truro Health Park, Infirmary Hill, Truro, Cornwall, TR1 2JA (01872) 243700

Provided and run by:
The Lander Medical Practice

Latest inspection summary

On this page

Background to this inspection

Updated 8 May 2019

The Lander Medical Practice is located within the Cornwall local authority area and is one of 65 practices serving the NHS Kernow CCG area. It provides primary medical services to approximately 18,200 patients.

Information published by Public Health England rates the level of deprivation within the practice population group as sixth on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice has a large proportion of patients registered of working age; 60.4% are aged 18-64 which is higher than the CCG average of 56.7% but comparable to the national average 62%. The practice has less patients over 65 at 19.6% when compared to the local average of 25.3%. Of the patients registered with the practice, 96.6% are White British, 1.1% are from mixed race ethnic groups, 1.8% are Asian, 0.2% are of Black African origin with the remaining 0.3% being of other races.

The practice is registered with the CQC and services are provided from one location at The Lander Medical Practice, Truro Health Park, Infirmary Hill, Truro, Cornwall, TR1 2JA. We visited this location as part of our inspection. The practice has six male GP partners and two female GP partners who are contracted to provide Personal Medical Services (PMS) and who are registered with the CQC for the following five regulated activities: diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease. PMS contracts offer local flexibility compared to the nationally negotiated General Medical Services (GMS) contracts by offering variation in the range of services which may be provided by the practice, the financial arrangements for those services and the provider structure.

The practice provides a range of services including maternity care, childhood immunisations, chronic disease management and travel immunisations and several enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract) including childhood immunisation, minor surgery, learning disability health checks, extended opening hours, and rotavirus and shingles immunisations. Private travel vaccinations are offered in addition to those available free of charge on the NHS.

The remainder of the practice team at The Lander Medical Practice is made up of five female salaried GPs, six practice nurses, four health care assistants, a practice manager, a deputy practice manager and twenty five administrative and reception support staff.

There was an in-house physiotherapy unit with a practice employed team and this had led to reduced waiting times for treatment. The average waiting time for urgent patients was 2-3 days and for routine patients it was a 3-4 week wait.

The surgery is open between 8am and 6.30pm Monday to Friday and booked appointments are available with a GP or nurse during these times. Pre-bookable appointments are also available to all patients at additional locations within the area, as the practice is a member of the local GP federation. These appointments are available between 6pm and 8pm Monday to Friday and between 8am and 8pm at the weekend.

The practice has opted out of providing out-of-hours (OOH) services to their own patients and directs patients to the out-of-hours provider by providing access details on their answerphone, on the website and on the outer door.

Overall inspection

Good

Updated 8 May 2019

We carried out an announced comprehensive inspection at The Lander Medical Practice on 21 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We have rated this practice as good overall, requires improvement for providing safe services and good for providing effective, caring, responsive and well led services.

We have also rated the practice as good for providing effective and responsive care to older people, people with long term conditions, families, children and young people, working age people, those whose circumstances may make them vulnerable and those experiencing poor mental health.

We rated the practice as requires improvement for providing safe services because:

  • Some staff records that we saw did not contain appropriate recruitment checks in line with current guidance.
  • Not all staff had up to date infection prevention training appropriate to their roles.
  • Some Patient Group Directions (PGDs) and Patient Specific Directions (PSDs), although rectified on the day of the inspection were incomplete.
  • Blood tests were not carried out prior to the prescribing of some high-risk medicines.
  • Due to the way significant events were recorded it was not always easy to see how the learning outcomes had been shared with the team.

We rated the practice as good for providing effective, caring, responsive and well led services because:

  • Patients received effective care and treatment that met their needs. The practice could demonstrate good patient outcomes were delivered.
  • Staff treated patients with kindness and respect and involved them in decisions about their care. The practice ethos was to provide an accessible and approachable patient-orientated service.
  • Patients could access care and treatment in a timely way. The practice organised and delivered services to meet their patients’ needs.

Although there were no breaches of regulations, the practice should:

  • Review all training in general, to ensure that staff receive training appropriate to their roles.
  • Continue to review and monitor PGDs and PSDs to ensure that they are correctly signed and, where appropriate, included in the patient record.
  • Continue to review and maintain the process for monitoring patients on high-risk medicines to ensure that appropriate blood tests are done prior to repeat prescribing by clinicians.
  • Consider implementing a log for safety alerts that is accessible to all staff.
  • Continue the process of staff appraisals to ensure that all staff receive an appraisal every 12 months.
  • Continue measures to increase the number of carers identified to above the national average of 2%
  • Should continue to work towards achieving the national target of 80% of eligible women attending for cervical screening

Please refer to the detailed report and the evidence tables for further information.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care