Fosse Medical Centre

Updated 19 November 2015

Fosse Medical Centre delivered primary care under a Personal Medical Services (PMS) Contract between themselves and NHS England. As part of the NHS Leicester City Clinical Commissioning Group (LCCCG), they serve the area of Leicester City West, with a population of over 8,300 patients.

There are three five  consulting rooms on the ground floor for Doctors and Nurses. Consulting rooms are located on the first floor and practice administration rooms are located on the second floor. The practice has ramps to the front and rear entrances of the building, with automatic doors that are suitable for wheelchair access. There is a disabled person’s toilet and baby changing facilities y located on the ground floor.

Just over 42% of the practice population are of the working age group those under the age of 18 measured at nearly 41%, those over the age of 65 are in the minority at just over 17%.

There are three male and one female GP. Services include access to two male partner GPs, one female partner GP and a salaried GP. The nursing team consisted of an advanced practitioner nurse, practice nurse, three health care assistants. A physiotherapist employed by the practice was also available.

The surgery is open from 7.00am – 6.30pm on Monday, Wednesday, Thursday and Friday, and from 8.00am - 6:30pm on Tuesday. and from 8.00am – 1.00pm on Saturday and Sundays. The clinical sessions of individual doctors and nurses vary within these hours. The practice GPs do not provide an out-of-hours service to their own patients and patients are signposted to the local out-of-hours service when the surgery is closed. at the weekends. This service is provided by Leicester City, Leicestershire and Rutland Out of Hours and is run by Central Nottinghamshire Clinical Services Limited.

The practice offers a full range of general medical services including maternity, child health, vaccination, blood testing, contraception, chronic disease management, warfarin and disease modifying anti-rheumatic drug monitoring. Treatment room services include travel vaccination services in addition to the child vaccinations. Leg ulcer management, minor injuries and minor illness advice is also offered by the practice nursing service.

There was An administration team that consisted of a full time practice manager, senior receptionist / deputy manager, seven reception staff f and a medical secretary   and a medical secretary. Patients told us the practice was well managed. are employed in the running of the practice were highly praised by all the patients we spoke with.

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fosse Medical Centre on 6 January 2015. 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 internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example this included the employment of a physiotherapist for seven hours a week in the practice. Therefore reducing the waiting times for appointments and resulting in patient’s ability to return to health and work sooner.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met people’s needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Reference Group (PRG).

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• We found the practice had initiated positive service improvements for their patients that were over and above their contractual obligations. This included the employment of a physiotherapist for seven hours a week in the practice. Therefore reducing the waiting times for appointments and resulting in patient’s ability to return to health and work sooner.

• The practice noted the high admission rates to Accident & Emergency locally from East European patients and as a result they included information in a Polish newsletter for patients on when they should or should not attend A & E.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

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  and more frequent reviews were carried out if required and medication needs were being met. More frequent reviews were carried out if required. 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.

The nursing team at the practice had been fully trained in long term condition management, including independent prescribing and insulin initiation. There were also GP leads for these.

An emergency, dedicated telephone number was issued to patients at high risk of emergency admission.

Updated 19 November 2015

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. There was a health visitor attached to the practice and there was a standard invite for them to attend weekly meetings or drop by at any time. 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 including weekends and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

All staff within the practice had completed safeguarding of children and vulnerable adult training. They had also all completed e-learning on the mental capacity act.

Updated 19 November 2015

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 dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The practice provided a dedicated telephone number in case patients had difficulties accessing the reception contact number to discuss concerns with a GP.

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

Updated 19 November 2015

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 also offers ed urgent on the day appointments and telephone advice.

The practice was also open from 7.00am – 6.30pm on Monday, Wednesday, Thursday and Friday,and from 8.00am - 6:30pm on Tuesday. and from 8.00am – 1.00pm on Saturday and Sundays. These extended hours particularly those at weekends gave much improved access for patients especially for those of working age

The practice offered in house physiotherapy, counselling, phlebotomy, minor surgery including joint injections and INR services (The international normalised ratio (INR) is a laboratory measurement of how long it takes blood to form a clot. It is used to determine the effects of oral anticoagulants on the clotting system). All forms of contraception were available within the practice.

Updated 19 November 2015

People experiencing poor mental health had received an annual physical health check. 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. It had a system 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.

Patients had access to a Serious Mental Health Practioner who attended the surgery one day each week via community health services; . t This was as a result of identified mental health issues that presented at the practice.

Updated 19 November 2015

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. It offered longer appointments for people with a learning disability. People identified as homeless or vulnerably housed were usually referred In most circumstances however this would be the exception rather than the rule as persons in vulnerable circumstances would be referred to Inclusion Healthcare Social Enterprise CIC in the city as that provided high quality primary health care services for homeless people. This included patients who were vulnerably housed; rough sleepers, squatters or sofa surfed in Leicester.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.