Crick Medical Practice

Updated 18 August 2016

Crick Medical Practice provides a range of primary medical services to the residents of Crick and the surrounding villages. The practice has been at its current location of 16 Watford Road, Crick, NN6 7TT since 1992. The practice has a branch surgery at Muncaster Way, West Haddon, Northamptonshire, NN6 7DU, which was not visited as part of this inspection.

The practice population is pre-dominantly White British with a higher than average number of patients over 40 years of age and a lower than average number between the ages 20 and 39 years of age. National data indicates the area is one of low deprivation. The practice has approximately 5,000 patients with services provided under a general medical services (GMS) contract, a nationally agreed contract with NHS England.

The practice is led by two GP partners; one male and one female, and they employ one female, salaried GP. The nursing team consists of two nurse prescribers and a health care assistant, all female. There are also a number of dispensary, reception and administrative staff led by a practice manager and deputy practice manager. They are a teaching practice and receive medical students from Warwick University.

The practice is open from 8am to 6.30pm Monday to Friday and offers extended opening hours from 6.30pm to 7.30pm on Wednesdays and from 8.30am to 10.30am one Saturday a month. There is a dispensary at the practice which is open from 8.30 to 2pm and 3pm to 6.30pm daily. The branch practice is open from 9am to 11.30am on Mondays, Tuesdays, and Thursdays.

When the practice is closed, out-of-hours services are provided by the Northamptonshire GP Out of Hours service which is run by Integrated Care 24 and can be accessed via the NHS 111 service.

Updated 18 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Crick Medical Practice on 13 April 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 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.
• The practice held regular staff and clinical meetings where learning was shared from significant events and complaints.
• They worked well with the multidisciplinary team to plan and implement care for their patients.
• Patients said they were treated with dignity and respect and they were involved in their care and decisions about their treatment. Staff were described as friendly, helpful and professional.
• 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.
• Urgent appointments were available on the day of request.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.

The areas where the provider should make improvement are:

• Continue to identify and support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 August 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.

• Performance for diabetes related indicators was comparable to the national average. The practice achieved 86% of available points compared to the national average of 89%.

• The local diabetes specialist nurse worked with the practice nurse to care for patients with complex diabetic needs.

• 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 more complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 18 August 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 relatively high for all standard childhood immunisations.

• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG average of 82% and the national average of 82%.

• 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.

Updated 18 August 2016

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.

• Care plans were in place and reviewed annually or sooner if required.

• The practice met with members of the multidisciplinary team every four weeks to discuss the care of this group of patients.

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

Updated 18 August 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.

• Extended hours appointments were available outside of normal working hours.

• 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 for patients who could not attend the practice.

Updated 18 August 2016

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

• 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 18 August 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 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.

• 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.

• The practice’s computer system alerted GPs if a patient was also a carer.The practice had identified 50 patients as carers which was 1% of the practice list.