Park Medical Centre

Updated 24 October 2016

Dr S Somerville and Partners (known as Park Medical Centre) is located in Leek, Staffordshire and is registered with the CQC as a partnership provider. The provider holds a General Medical Services (GMS) contract with NHS England and is a member of the North Staffordshire Clinical Commissioning Group (CCG). A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of contract.

The practice building is owned and managed by six GP partners (three male and three female) providing 4.2 whole time equivalent (WTE) in addition to one salaried GP. The partners are assisted by a practice matron and a team of advanced nurse practitioners, practice nurses, health care assistants and phlebotomists. The clinical team is supported by a practice manager, an office manager, reception manager, administration and reception staff. The practice employs a total of 43 staff.

The practice provides its patient population with extended and updated modern facilities. The premises and car park have recently been extended, providing a two-storey building with a large car park located to the rear of the premises. Part of the building is leased to the Staffordshire and Stoke on Trent Partnership NHS Trust and is occupied by the District Nursing Community Service. Another section of the building is leased to a pharmacy, which is accessible from the main reception area.

The practice serves a population of 12123 patients. The practice serves a higher population of patients aged 45 years and above compared to CCG and England averages and a lower population of patients aged 20-40 years. The practice has a lower percentage of unemployed patients (3%) compared to the local average of 4% and the national average of 5%. The percentage of patients with a long-standing health condition is 58%, which is comparable to the local CCG average of 57% and the national average of 54%.

The practice is open daily from 8am to 6pm Monday to Friday. Appointments with GPs are available from 8am to 11.30am and from 2.30pm to 5.30pm. A duty GP is available from 8am to 6pm to provide flexibility for patients. Appointments with nurses are available from 8am to 5.50pm. Extended surgery hours appointments are offered every Saturday from 8am to 11am with a GP or nurse. Telephone consultations are available during mornings and afternoons. Appointments can be booked in person, on-line or by telephone.

The practice is an accredited undergraduate teaching practice and provides placements for GP registrars and nurses. The practice also works closely with a local university school of medicine and provides placements for medical students.

Updated 24 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr S Somerville & Partners on 20 July 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from incidents were maximised.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.

• The practice had a clear vision, which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements. Staff felt supported by the management team.
• 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.
• The practice had identified 507 patients as carers (4% of the practice list) and worked closely in conjunction with external support agencies to promote the work of carers and provide support and advice to carers.

We saw an area of outstanding practice:

• The practice used innovative and proactive methods to improve patient outcomes. For example, the practice had appointed a practice matron to lead a designated care quality team for managing elderly patients in the community and those patients with long-term conditions.

However there were areas of practice where the provider should make improvements:

• Improve the system for ensuring patients receive the necessary monitoring before prescribing high risk medicines to ensure continuing patient safety, and to minimise potential risks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 October 2016

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

• The Care Quality Team focused on providing high quality holistic clinical management of those with multiple long-term conditions and those at risk of emergency admission. They provided a full range of nurse led chronic disease management clinics. The clinics became fully operational in 2016 after a successful pilot following development over 12 months including patient engagement, clinical team education and training.

• The practice had developed strong clinical links with wider local physical and mental health and social care providers in a locality multidisciplinary provider (MCP) pilot.

• Data from the 2014-15 Quality Outcomes Framework (QOF) showed that the practice was performing in line with local and national averages. For example, 78% of patients on the diabetes register had received a blood pressure check within the last 12 months compared to the local average of 76% and the national average of 78%. The practice told us that the unverified data for 2015/16 had shown significant improvements.

• The practice had a diabetes specialist nurse and a lead GP providing high quality care including insulin initiation and support to those with complex needs. The diabetes service was more convenient for patients and reduced the need for referral to secondary care.

• Longer appointments and home visits were available when needed.

• Patients had a structured annual review to check their health and medicines needs were being met. The practice provided a ‘one stop’ generic chronic disease service enabling patients’ needs to be reviewed on the same day. The practice had an effective call and recall system in place to ensure people’s health needs were regularly kept under review.

• The practice had GPs with a Special Interest (GPwSI) in dermatology and musculo-skeletal conditions within the practice that helped reduce referrals to secondary care.

• The practice had developed strong links with the respiratory service to maximise multidisciplinary team working and had provided respiratory and cardiovascular disease training across the nurse, health care and GP teams.  

Updated 24 October 2016

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

• The practice provided a range of contraception and sexual health services including emergency contraception and coil insertion.

• 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 comparable with the CCG average for all standard childhood immunisations.

• The practice’s uptake for the cervical screening programme was 79%, which was comparable with the CCG and national average of 82%. The Patient Participation Group had run a health promotion campaign in the practice to raise awareness during cervical cancer prevention week.

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

• We saw positive examples of joint working with midwives and health visitors including case reviews.

• The practice had a strong online presence with a website, online services and its own page on a social media website. The practice website provided a link for young patients to access information about various health matters.

Updated 24 October 2016

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

• The practice had appointed a practice matron to lead the clinical management of their frail elderly population.

• The practice had established a Care Quality Team (CQT) responsible for personalised care planning and providing proactive clinical care to the frail elderly. They had completed in excess of 450 care plans of the 499 patients on the register, equating to over 5% of the patients on the avoiding hospital admissions register. The CQC initiative had a direct influence on older people and hospital admissions. A & E attendance and non-elective admission rates in their frail elderly population were consistently below CCG average.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Regular meetings were held with external health and social care professionals to discuss patients with more complex needs and vulnerability.

• Palliative care meetings were held in house involving the CQT team, their palliative nurse specialist, district nursing team and GP with case discussion and reflection to enable quality improvement.

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

• Admission avoidance meetings were regularly held to discuss cases, learn lessons, act upon findings and disseminate information.

Updated 24 October 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.

• Telephone consultations were available with a GP or a Nurse Practitioner at an agreed time and preferred telephone number provided.

• Pre-bookable appointments were available on a Saturday morning from 8am to 11am with a GP and a Nurse.

• The practice provide a phlebotomy service (removal of blood from a patient) to avoid patients having to travel to hospital.

• The PPG had been actively involved in a variety of health promotion campaigns within the practice to help raise patient awareness. These included cervical cancer prevention, dementia awareness, deaf awareness, national diabetic awareness week and national no smoking.

Updated 24 October 2016

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

• The percentage of patients with a diagnosed mental health condition who had a comprehensive, agreed care plan documented in their record in the preceding 12 months was 98%, which was higher that the CCG average of 87% and the national average of 88%.

• The percentage

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

• The PPG had promoted a dementia awareness month within the practice.

• 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 24 October 2016

The practice is rated as good for the care of people who circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability and carers. The practice had a carers support policy in place and a designated carers lead. The practice had identified 507 patients as carers (4% of the practice list) and worked closely in conjunction with external support agencies to promote the work of carers and provide support and advice to carers.

• The practice had a meet and greet policy in place for patients with disabilities who required help during their visit to the practice. They were escorted to a waiting area by a receptionist, greeted by a clinician, and escorted to the appropriate consulting room. The practice offered longer appointments for patients with a learning disability and had a dedicated clinic. They had developed close links with the learning disability nurse and had held a recent educational event.

• 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 held a Carers’ Hub campaign week in the practice. During the inspection we saw an advisor was available in the waiting room to offer support and advice to patients.

• 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.

• Translation services were available. Languages spoken by clinical staff included Polish, Hindi, Telugu, Urdu, Punjabi, German and French.