The Hedges Medical Centre Also known as The Hedges Medical Centre

Updated 2 June 2016

The Hedges Medical Centre provides primary medical services to approximately 5,405 patients in Leicester City.

It is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning; maternity and midwifery services and surgical procedures.

At the time of our inspection the practice employed five GPs (four female and one male), two registrars (a registrar is a qualified Doctor who is training to become a GP), one 4th year medical student, a practice manager, office manager, five receptionists, a secretary, a summariser, two practice nurses, a health care assistant and a domestic.

The surgery is open from 8am until 6.30pm Monday to Friday with the exception of Thursday when the practice is open until 8.30pm. The practice is part of a pilot scheme within Leicester City which is operating until 31 March 2016. This scheme offers patients an evening and weekend appointment with either a GP or advanced nurse practitioner at one of four healthcare hub centres. Appointments are available from 6.30pm until 10pm Monday to Friday and from 9am until 10pm on weekends and bank holidays. Appointments are available by walk in, telephone booking or direct referral from NHS 111.

The practice is located within a purpose built health centre built in 2000 and includes eight consulting rooms and one treatment room.

The practice has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering care services to local communities.

The practice has one location registered separately with the Care Quality Commission (CQC) which is The Hedges Medical Centre – SA Bailey, Pasley Road, Eyres Montell, Leicester, LE2 9BU.

The practice is a training practice and delivers training to GP Registrars. A GP Registrar is a fully qualified Doctor who is training to become a GP.

The practice has an active patient participation group (PPG) which has been in place for four years who meet on a regular basis.

The practice has a higher population of patients between the ages of 0-18 years of age. 62.9% of the patient population have a long standing health condition.

The practice offers on-line services for patients including ordering repeat prescriptions, booking routine appointments and viewing patients summary care records.

The practice lies within the NHS Leicester City Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

Updated 2 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Hedges Medical Centre on 11 February 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.

• The practice had an active patient participation group (PPG) who met on a monthly basis. Members of the PPG delivered ‘social prescribing’ sessions twice a month in the practice giving advice to patients regarding social activities available to them within the local community with an aim to improve mental health and well-being.

• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 June 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.

• 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.

• Performance for diabetes related indicators was 94.5% which was better than the national average of 89.2%.

• 1.4% of practice population were identified as at risk of unplanned hospital admission and had a care plan in place which was reviewed on a regular basis.

• Care plans were in place for patients who were at end of life where appropriate.

• The practice provided  an enhanced specialist service for patients with diabetes.

• Longer appointments and home visits were available when needed.

Updated 2 June 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.

• 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 practice’s uptake for the cervical screening programme was 75.2%, which was comparable to the CCG average of 68.9% and the national average of 74%.

• 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.

• The practice provided weekly health visitor and midwifery led clinics and also a vaccination and immunisation clinic.

• The practice held three monthly child concern meetings with school nurses and health visitors to review patients’ needs and any concerns were discussed and action plans implemented.

• Four GPs were trained to fit long acting reversible contraceptives (LARCS) and flexible appointments were available for this service. The practice also provided an enhanced sexual health service for patients which included patients who were registered with other GP surgeries within Leicester City.

Updated 2 June 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.

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

• There was a named GP for all patients over the age of 75.

Updated 2 June 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.

Updated 2 June 2016

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

• Performance for mental health related indicators was 91.2% which was comparable to the national average of 92.8%.

• 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.

• The practice provided weekly appointments with the Drugs and Alcohol Team.

• A mental health facilitator provided regular appointments for patients suffering with poor mental health and provided annual health checks and advice regarding mental health.

• The practice referred patients to members of the patient participation group (PPG) who delivered ‘social prescribing’ sessions held twice monthly in the practice.  These sessions delivered advice to patients regarding social activities available to them within the local community to help to improve mental health and well-being. 

Updated 2 June 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 had 57 patients on this register and offered longer appointments for these patients.

• 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.

• Practice nurses carried out annual visits to patients who were either housebound or resided in care and residential home to administer influenza vaccinations and carry out chronic disease management reviews and/or blood tests where required.