Archived: The Centre Surgery

Updated 8 July 2016

he Centre Surgery is located in the centre of Hinckley in north west Leicestershire. The practice is housed in a health centre built in the 1970s and which it shares with a number of other services. There is a lift to the upper floor where the practice is situated and also a ramp from the car park where there are disabled parking bays. There is a hearing loop in the reception area.

The Practice has a General Medical Services (GMS) contract.

• The practice has three full-time GP partners, one of whom is female.There are three practice nurses and a health care assistant who are all female. There are also administrative staff including a practice manager and reception team.

• The practice is open between 8.00am and 6.30pm Monday to Friday. Appointments are generally available from 8.30am to 11.40am and from 3.00pm to 5.20pm Monday to Friday. Some of these are telephone appointments.

• Out of hours services are provided by CNCS (Central Nottinghamshire Clinical Services). Patients are directed to the correct numbers if they phone the surgery when it is closed.

• The practice has 5578 patients registered with it with a relatively high proportion of patients over 60.

• Although Hinckley is a lively market town it does have some pockets of deprivation.

Updated 8 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Centre Surgery on 13 April 2016. Overall the practice is rated as good.

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

• Information about safety was recorded, monitored, reviewed and any issues were addressed in a timely way. There was an effective system in place for reporting and recording significant events and complaints.
• 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 kindness, 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 as a result of complaints and concerns.
• Urgent appointments were available on the same day
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The premises were clean and well-maintained as part of the tenancy agreement.
• 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.

• The areas where the provider should make improvement are:

• The practice should ensure it is involved with cleaning audits done by the landlord and receives reports so that it can monitor the service it receives.

• The practice should obtain copies of risk assessments done by the landlord related to the safety of the premises.

• The practice should endeavour to identify all its patients who provide care for friends or relatives.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 July 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 worked closely with visiting specialist nurses.

• The practices’ performance for diabetes management was similarto the national average, for example, 87% of diabetic patients had had a recent foot examination compared to the national average of 88%

• Patients were referred to local services for lifestyle advice related to their conditions.

• Patients at risk of hospital admission were identified as a priority and had a personalised care plan. An alert on their record ensured that receptionists were aware that these patients should be offered same-day contact preferably with their usual doctor.

• 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.

• Where patients had a number of long-term conditions the practice took a holistic approach and offered them synchronised appointments so that where possible all their conditions could be reviewed during one visit to the surgery.

• Home visits were available when needed.

Updated 8 July 2016

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

• There were systems in place to identify 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 similar to the locality rates for all standard childhood immunisations (95-97%)

• The practice offered a wide range of contraceptive services.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Chlamydia screening packs were available in different areas of the practice.

• Data showed 78% of eligible women had received a cervical screening test. (National average 82%)

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice offered 24 hour and six week baby checks.

Staff told us they had good working relationships with midwives and health visitors who were based in the same building.

Updated 8 July 2016

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

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

• The practice had identified patients most at risk of hospital admission. Each patient had a personalised care plan and an alert was put on the patient record. Any admissions were reviewed to identify avoidable factors.

• The practice also referred frail, elderly patients to a regional older persons unit staffed by a geriatrician and multi-disciplinary team where they were usually seen with 48hours for a review of medication and for other health and social needs to be addressed.

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

• The practice provided care for approximately 40 patients living in local care homes and provided home visits when needed.

Updated 8 July 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 offered services that were accessible, flexible and, where possible, offered continuity of care.

• Pre-bookable appointments were available from 8.30am to 5.20pm Monday to Friday although the majority were available on the day.

• Pre-bookable telephone consultations were also available.

• Urgent same-day appointments and telephone consultations were available.

• Nursing staff offered a travel vaccination service.

• The practice offered a range of online services as well as a full range of health promotion and screening that reflected the needs for this age group.

• There was on-line access to book or cancel appointments and for repeat prescriptions.

Updated 8 July 2016

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

• 74% of patients living with dementia had a face-to-face care review in the previous 12 months

• The practice regularly worked with multi-disciplinary teams in the case management of the people experiencing poor mental health, including those with dementia. Patients were also referred to the local Memory Clinic.

• The practice carried out advance care planning for patients with dementia.

• The primary mental health facilitator was based in the practice building. This helped with smooth and prompt referral of patients who needed access to psychological therapies.

• 100% of patients with mental health problems had a comprehensive agreed care plan on their records which was comparable with national figures.

• The practice had also provided patients experiencing poor mental health with information 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 when 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 8 July 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 who were homeless, had alcohol or substance misuse problems, and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability and staff were aware of individual patient needs such as what time of day a patient might prefer their appointment.

• Patients with learning disabilities were offered annual health checks. 50% had attended half way through the year.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Some were referred to a community matron to ensure that their health and social care needs were identified.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice supported homeless patients who were trying to find housing and support.

• 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.