Archived: Cloisters Medical Practice

Updated 9 July 2015

The Cloisters Medical Practice was formed in April 2002 and is sited within the Greenhill Health Centre near Lichfield town centre. Other health services are also situated in the same building these include another GP practice, a pharmacy, podiatry, health visitors, community nursing, dentistry and mental health services. The Greenhill Health Centre premises are owned by NHS Property Services Limited who undertake the ongoing maintenance of the building and premises. Lichfield is one of the less deprived areas of the NHS South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group (CCG.

The practice provides services to mainly older people. This includes providing regular support and care to older people living in care homes.

The clinical and nursing team comprises four GP Partners, four salaried GPs (three male and five female), three practice nurses and two clinical support workers. A practice manager, reception, administrative and secretarial staff provide staffing support for the practice. The practice is approved for teaching medical students and is aspiring to become a training practice for GP Registrars (qualified doctors who undertake additional specialist training to gain experience and higher qualification in General Practice and family medicine).

The practice has a General Medical Services (GMS) contract with NHS England for delivering primary care services to their local community. The practice provides general medical services to a list of approximately 8,700 patients. Services provided include the following clinics; vaccinations, asthma, diabetes and wellbeing screening clinics.

The practice does not provide an out of hour’s service to their patients. It has alternative arrangements with Staffordshire Doctors Urgent Care Ltd (SDUC) for their patients to be seen when the practice is closed.

Updated 9 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cloisters Medical Practice on 20 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, responsive, effective, caring and

well- led services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles, with the exception of infection control and prevention. Further staff training needs had been identified and planned.
• 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.
• Patients said that they did not always find it easy to make an appointment with a named GP however urgent appointments were 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.

We saw one area of outstanding practice:

• The practice provided a service to a community of people who lived on houseboats and barges. The practice offered them the opportunity to register as permanent or temporary patients and ensured that they had the means to contact and communicate with them when needed.

However there was one area of practice where the provider needs to make improvements.

Action the provider SHOULD take to improve::

Ensure that all staff receive infection control training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 July 2015

The practice is rated as good for the care of people with long-term conditions. GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 9 July 2015

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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

Updated 9 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in end of life care. The practice had identified concerns with the reduction of services for patients with dementia and were actively looking at ways that they could address this. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All patients over the age of 75 years had a named GP and was given the opportunity to nominate a GP of their choice. The shingles and influenza vaccine was offered to those older people who were eligible to receive them. A health care assistant carried out planned home visits to older people in their homes including those living in care homes .

Updated 9 July 2015

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. The practice held early morning and evening appointments each week.

Updated 9 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had noted that a number of their patients experiencing poor mental health had not had an agreed care plan completed. The practice had taken appropriate action to address this. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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 including MIND and SANE. Following an audit to review the management of patients experiencing poor mental health the practice had ensured that systems were in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 9 July 2015

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. It had carried out annual health checks for people with a learning disability and all of these patients had received a follow-up. The practice offered longer appointments for patients with a learning disability. The practice provided a service to a community of people who lived on houseboats and barges. The practice offered them the opportunity to register as permanent or temporary patients and ensured that they had the means to contact and communicate with them when needed. The practice worked with these patients to provide care and treatment to suit their lifestyle and this included those with end of life care needs.