Dr Norcross & Partners

Updated 17 January 2017

Dr French and Partners also known as Ansdell Medical Centre is located in Lytham St Anne’s Lancashire. The practice is in purpose built premises in a residential area of the town. There is easy access to the building and disabled facilities are provided. There is a car park for the practice.

The practice is part of Fylde and Wyre Clinical Commissioning Group and provides primary medical services under a General Medical Services contract with NHS England.

There are five GP partners working at the practice, four female and one male and one salaried GP (male). There are two nurse practitioners, three practice nurses, two health care assistants, a pharmacist (medicines management team), a medicines management assistant and one phlebotomist. There is a full time practice manager, one assistant practice manager and a team of administrative staff.

The practice opening times are Monday to Friday 8.30am until 6pm and appointments are available from 8.30am until 5.40pm. Extended hours appointments are available 3 days per week Tuesday, Thursday and Friday from 8am.

There are 9308 patients on the practice list. The majority of patients are white British with a high number of elderly patients and patients with chronic disease prevalence.

Information published by Public Health England rates the level of deprivation within the practice population group as eight on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest.

Average male and female life expectancy for the practice is 79 years (m) and 84 years (f), which is similar to the national average of 79 and 83 respectively.

Patients requiring a GP outside of normal working hours patients are advised to contact the 111 and the call will be re-directed to the out-of-hours service.

Updated 17 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ansdell Medical Centre on 1 December 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.
• 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 said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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.

We saw an area of outstanding practice:

• The GPs and practice staff supported a number of charities including regular donations to a local food bank. Staff also made donations to the food bank rather than buying Christmas cards and gifts for each other. The GPs were able to refer patients, if needed, to the food bank for support.

The areas where the provider should make improvements are:

• Make improvements to the system to review how significant events are actioned and recorded to help better identify trends.

• Review the child safeguarding register to ensure all patients included on the register are of the appropriate age.

• Review the recruitment policy to include obtaining Disclosure and Barring Service checks for all posts requiring such checks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 January 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 staff had links with multidisciplinary teams such as; the community and heart failure matrons, palliative care nurses from the local hospice, the hospice at home team and Lancashire wellbeing.

The practice worked with the ‘extensive care’ service. A team of health and social care professionals working together to provide the most appropriate package of care for patients who have two or more chronic diseases.

• The percentage of patients with COPD (diagnosed on or after 1 April 2011) in whom the diagnosis has been confirmed by post bronchodilator spirometry between 3 months before and 12 months after entering on to the register was 97% which was better than the CCG and national average of 90% and 89% respectively.
• The percentage of patients with COPD who have had influenza immunisation in the preceding 1 August to 31 March was 99% which was similar to the CCG and national average of 98% and 97% respectively.
• 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.

Updated 17 January 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.
• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (available data 01/04/2014 to 31/03/2015) was 82% which was similar to the CCG and national average of 84% and 81% respectively.
• 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, health visitors and school nurses.

Updated 17 January 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 was taking part in a ‘housebound’ project initiated by the neighbourhood team (NHS Fylde and Wyre CCG). This service provided chronicdisease monitoring and management for patients who were unable to attend the practice chronic disease clinics.

Updated 17 January 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 reflects the needs for this age group.

Updated 17 January 2017

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

• 75% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was worse than the national average.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive care plan documented in the record, in the preceding 12 months, agreed between individuals, their family and/or carers as appropriate was 72% which was below the CCG and national average of 88%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood pressure in the preceding 12 months was 76% which was below the CCG and national average of 90% and 89% respectively.
• 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 17 January 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 homeless people, travellers and 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. For example, the practice worked with the local vanguard project to ensure patients with complex care needs received a fully integrated service with access to both health and social care professionals.

• 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 held a child safeguarding register however, this had not been reviewed and contained patients who were over the age of 18 years.

• The partners operated an on call rota to provide palliative/end of life care to ensure that patients received continuity of care. These patients were reviewed on a weekly basis by the GPs and the multi-disciplinary health care team.