Archived: Glenside Medical Centre

Updated 18 November 2016

The practice is situated in the Devon town of Plympton which is approximately five miles from the city of Plymouth. The practice provides a general medical service to approximately 7000 patients of a diverse age group.

Information published by Public Health England rates the level of deprivation within the practice population group as nine on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest. Public health data showed that 1.6% of the patients are aged over 85 years old which is much lower than the local average (CCG) of 3.1% and the national average of 2.3%.

There are four GP partners who hold managerial and financial responsibility for running the practice, two female and two male. They are also two salaried GPs. They are supported by the practice manager, deputy practice manager, clinical manager, nurse prescriber, practice nurse, a health care assistant, a phlebotomist and additional administration staff. Patients also have access to community nurses, health visitors and midwives. The practice is a training practice for under graduates and post graduates.

The practice is routinely open from Monday to Friday from 8am to 6pm. There are two early morning appointment sessions for patients who work full-time, these are on Monday and Friday starting at 7am. There are also evening appointments on Mondays and Tuesdays every week from 6.30pm to 7.30pm. The practice offers a range ofappointment types including book on the day, telephone consultations and advance appointments.

The practice has opted out of providing out-of-hours services to their own patients and refers them to an out of hour’s provider via the NHS 111 service. This information is displayed on the outside of the practice, on their website, and in the patient information leaflet.

Updated 18 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Glenside on 8 December 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.
• 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.

The area where the provider should make improvements is:

• Improve the availability of non-urgent appointments by improving telephone access, in line with patient feedback. Audit and evaluate the improvement.

• Professor Steve Field (CBE FRCP FFPH FRCGP)  Chief Inspector of General Practice

Updated 25 February 2016

The practice is rated as good for the care of patients 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. 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 medicine 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.

The practice had GPs with special interests including musculoskeletal medicine skills, chronic pain and dermatology. Patients were referred internally to the specific GP and had treatment within the practice, saving them from having to attend an outpatient’s appointment at Derriford Hospital.

Special messages were attached to the computerised patient records that Out of Hours services could see, to ensure consistent care. If a patient was admitted to hospital, the practice sent a written summary to the hospital with details of both the current problem and of past medical history including current medicines and allergies, to help enable consistent and safe of care.

The practice extended hour’s appointments to allow access to working age patients with chronic diseases.

Updated 25 February 2016

The practice is rated as good for the care of families, children and younger 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 patients who had a high number of A&E attendances. Immunisation rates were good for all standard childhood immunisations.

Patients told us that children and young patients 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. The practice always offered same day GP appointments to children when requested. There were after school appointments with a nurse for children and young patients who need immunisations or asthma reviews.

We saw good examples of joint working with midwives, health visitors and school nurses. A community midwife ran a weekly clinic from the practice.

Extra support was given to the needs of the families of service personnel who had unique needs including social isolation and periods of single parenting.

Updated 25 February 2016

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

The practice offered proactive, personalised care to meet the needs of the older patients in its population. It was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. The GPs also undertook twilight visits when required rather than asking patients to use the out of hour’s service, this provided continuity of care.

Every patient had their own named GP, however, patients were able to see the GP of their choosing.

The palliative care register was reviewed weekly at a clinical meeting. There was good relationships with other members of the multi-disciplinary team including district nurses, health visitors and with the pharmacy to ensure elderly/frail patient medicines were well managed.

The practice has level access throughout. There were wheelchairs for patients to use if required.

Updated 25 February 2016

The practice is rated as good for the care of working 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.

Appointments were available at 7am on two mornings a week to support those patients who were working.

Updated 25 February 2016

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

71.3% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. For those that refused or did not attend, follow up letters were sent. This recall work was ongoing.

The practice regularly worked with multi-disciplinary teams in the case management of patients 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.

Updated 25 February 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

The practice held a register of patients living in vulnerable circumstances including homeless patients, and those with a learning disability. It offered longer appointments for patients with a learning disability. There was a person centred approach, which ensured patients with communication needs received information in a format that was most appropriate for them. The practice had completed 100% of annual health checks for patients with a learning disability.

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

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.