Northfield Medical Centre

Updated 10 February 2017

Northfield Medical Practice Villers Court, Leicester is a member of the NHS East Leicestershire and Rutland Clinical Commissioning Group (CCG). General Medical Services (GMS) are provided under a contract with NHS England.

The surgery is in a purpose built building over two floors, with all public areas and consulting and treatment rooms on the ground floor. There is a substantial car park with disabled parking bays and a disabled ramp to the front door.

The practice is located in an area of least deprivation in Blaby on the outskirts of Leicester. Information published by Public Health England rates the level of deprivation within the practice population group as nine on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice currently has a patient list size of 11,182. The average life expectancy of the practice population is comparable with both CCG and national averages for males at 80 years. Life expectancy for females is also comparable with CCG and national averages at 85 years (CCG 84 years and national average 83 years). Age groups and population groups within the practice population are comparable with CCG and national averages.

There are seven GPs and six registrars at the practice. Nursing staff consist of a two practice nurses and two health care assistants (HCA); all of whom are female. There are two assistant practice managers, and a team of reception and administrative staff who oversee the day to day running of the practice.

Northfield Medical Practice is a teaching and training practice. They are accredited to train doctors to become GPs (registrars) and to support undergraduate medical students with clinical practice and theory teaching sessions.

The practice has good working relationships with health and social services to support provision of care for its patients. Locally, they have close working links with three care and nursing homes. Regular visits are made by the clinicians to these sites.

The practice is open Monday 8am to 7pm, Tuesday, Wednesday and Friday 8am – 6:30pm and Thursday 8am- 7:30pm.

In addition to pre-bookable appointments that could be booked in advance, the practice has daily urgent appointments in place and ‘sit and wait’ appointments at the end of each surgery.

Updated 10 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Northfield Medical Practice on 2 December 2016. Overall the practice is rated as good for providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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

• The practice staff had a very good understanding of the needs of their practice population and were flexible in their service delivery to meet patient demands; such as providing flexible GP appointments when required.
• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive.
• There was evidence of an all-inclusive team approach to providing services and care for patients.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• There was good access to clinicians and patients said they found it easy to make an appointment. There was continuity of care and if urgent care was needed patients were seen on the same day as requested.
• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance.
• The practice promoted a culture of openness and honesty. There was a nominated lead for dealing with complaints and significant events. All staff were encouraged and supported to record any incidents. There was evidence of good investigation, learning and sharing mechanisms in place.
• Risks to patients were assessed and well managed.
• There was a safeguarding lead in place and systems to protect patients and staff from abuse.
• 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 participation group. For example the practice had reviewed access to appointments and improved the telephone system.
• Staff said they were proud to work at the practice and felt they delivered good, quality service and care to patients.
• The practice complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 February 2017

The practice is rated as good for the care of people with long term conditions.

• The practice nurses had lead roles in the management of long term conditions, supported by the GPs.
• A GP led diabetes clinic was in place with trained nurse and a specialist community diabetes nurse to help ensure coordinated delivery of care.
• 94% of patients with diabetes had an HbA1C result which was within normal parameters, which was higher than both figures at 93% and 88%. (HbA1c is a blood test which can help to measure diabetes management.)

• Annual reviews were undertaken to check patients’ health care and treatment needs were being met.
• 75% of patients diagnosed with asthma had received an asthma review in the last 12 months, compared to 73% locally and 70%nationally.
• 91% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months, compared to 89% locally and 90% nationally.

Updated 10 February 2017

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

• The practice worked with midwives and health visitors to support the needs of this population group. For example, the provision, ante-natal, post-natal and child health surveillance clinics.
• 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 high for all standard childhood immunisations.
• Patients and staff told us children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day access was available for all children under the age of five.
• Sexual health, contraceptive and cervical screening services were provided at the practice.
• 84% of eligible patients had received cervical screening, compared to 79% locally and 76%.nationally.

Updated 10 February 2017

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

• Proactive, responsive care was provided to meet the needs of the older people in its population.

• Registers of patients who were aged 75 years and above and also the frail elderly were in place to ensure timely care and support were provided. Health checks were offered for all these patients.

• The practice worked closely with other health and social care professionals, via multi-disciplinary care teams. This helped housebound patients receive co-ordinated care and support and reduced hospital admissions.

• The practice worked with local nursing and care homes providing regular support and guidance.

Updated 10 February 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these patients 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 telephone consultations, online booking of appointments and ordering of prescriptions.
• Early morning and evening appointments were offered to increase flexibility for working patients.
• The practice offered a range of health promotion and screening that reflected the needs for this age group.
• Health checks were offered to patients aged between 40 and 74 who did not have a pre-existing condition. The practice had completed 406 of these health checks which equates to 66% of invited patients who attended.
• Travel health advice and vaccinations were available.
• 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.

Updated 10 February 2017

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

• 77% of patients diagnosed with dementia had received a face to face review of their care in the last 12 months, which is comparable to the local and national averages 80% and 83%.
• Early diagnosis rates of dementia with ability to offer early intervention and support. Results indicate 71% compared to CCG average of 63%.
• The practice had developed comprehensive care plans for patients with patients diagnosed with dementia.
• 97% of patients who had a severe mental health problem had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was higher than 94% local and national average of 90%.
• GP Led substance misuse clinic held at the practice to provide accessible support and advice and offer a range of vaccinations and health screening.
• Same day appointments / phone consultation were made for patients experiencing poor mental health.
• Patients and/or their carer were given information on how to access various support groups and voluntary organisations.

Updated 10 February 2017

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

• Staff knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.
• We saw there was information available on how patients could access various local support groups and voluntary organisations.
• The practice nurse and health care assistant had recently completed updated training to provide annual reviews of care for patients with a learning disability.
• A GP Led substance misuse clinic was in place to provide accessible support and advice and offer a range of vaccinations and health screening.