Archived: Parkhill Medical Practice

Updated 4 February 2016

Parkhill Medical Practice was inspected on Tuesday 17 November 2015. This was a comprehensive inspection.

The main practice is situated in the coastal town of Torquay, Devon. The practice provides a primary medical service to 9,158 patients. A total of 24% of these patients were aged 65 years or older. The practice is a teaching practice for medical students and a training practice. The practice currently had one GP Registrar.

There was a team of six GPs partners, two female and four male. There were also two female salaried GPs. Some GPs worked part time and some full time. Partners hold managerial and financial responsibility for running the business. The team were supported by a practice manager, four practice nurses, three health care assistants, one phlebotomist and additional administration staff.

Patients using the practice also had access to community nurses, mental health teams and health visitors who are based at the branch practice. Other health care professionals visit the practice on a regular basis.

The contracted opening hours of the practice are 8am to 6.30pm Tuesday to Friday. Appointments can be offered anytime within these hours. Extended hours surgeries are offered at the following times on Mondays 7am until 8am and 7am – 8am every other Thursday. In addition the practice opened every other Monday 6.30pm – 8pm.

Outside of these times patients are directed to contact the Devon Doctors out of hour’s service by using the NHS 111 number.

The practice offered a range ofappointment types including book on the day, telephone consultations and advance appointments.

The practice had a General Medical Services (GMS) contract with NHS England.

During our inspection we visited the main practice at Parkhill Road, Torquay TQ1 2AR. Regulated activities are provided from this location and also from a branch location at 13-15 Sherwell Valley Road, Torquay TQ2 6EJ. We visited the main practice at Parkhill Road. We did not visit the branch location at Sherwell Valley Road.

Updated 4 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkhill Medical Practice on 17 November 2015. 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 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.
• Patients said they found it easy to make an appointment with a named GP and that 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 4 February 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.

• The percentage of patients with diabetes, on the register, who have had a flu vaccination in the last 12 months, was 95%, which was higher than the national average of 93%.

• 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 medicines 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 4 February 2016

The practice is rated as good for the care of families, children and young people.

• There were information displays in reception relevant to young people. These included information on sexual health, details of Torbay’s condom card scheme and free chlamydia testing packs.

• 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.

• 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 cervical screening rate was 78%. This was comparable with the national average of 81%. Reminders were sent to patients who failed to appear for their appointment.

• 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, health visitors and school nurses.

Updated 4 February 2016

The practice is rated as good for the care of older people.

• The practice used a wide range of services to support this age group including easy telephone access to consultants and radiology, intermediate care beds, the community matron, falls and balance classes, the social care teams and a carers support worker.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

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

• The practice had close links with local pharmacies to help identify patients who might not be managing medication well, such as those patients who repeatedly visited the pharmacist asking for medicines when they should have sufficient supply to last them. The practice provided prescription delivery and blister packs to support patients.

• The practice had level ground floor access to treatment rooms, a hearing aid induction loop, a wheelchair on site and the waiting room had a range of seating appropriate to support people with a range of different needs.

Updated 4 February 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 provided smoking cessation support clinics. Of 2,692 patients recorded as smokers in 2014-15 who had expressed a wish for support to stop smoking, so far 58.5% had successfully stopped smoking.

• 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 had systems in place to identify military veterans and ensure their advanced access to secondary care in line with the national Armed Forces Covenant.

Updated 4 February 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 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.

• It 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 people with mental health needs and dementia.

Updated 4 February 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 homeless people, travellers and those with a learning disability.

• It offered longer appointments for people with a learning disability.

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

• The practice held an ‘Immediate attention’ list in reception for vulnerable patients who needed prompt access to a GP.

• The practice displayed information about support agencies for survivors of domestic violence and staff had been trained in this area.

• 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.

• It had told vulnerable patients about how to access various support groups and voluntary organisations.

• The practice included this group in its proactive planning and case reviews for avoiding unplanned hospital admissions enhanced service.

• Most staff knew how to recognise signs of abuse in vulnerable adults and children.

• Most 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.