Archived: Nene Valley Medical Practice

Updated 20 August 2015

Nene Valley Medical Practice provides general medical services Monday to Friday from 8am to 6.00pm with a duty doctor available Monday to Friday until 6.30pm. The practice offered extended hours appointments to to enable better access for patients at variable times and days during the week. Weekday mornings from 7am to 8am or evenings 6.30pm to 8pm, and Saturday mornings from 8am to 11am. These were only available as pre-booked appointments and not on the day. The practice provides general medical services to approximately 12,493 patients and is situated in Clayton, Orton Goldhay, near Peterborough. The purpose built premises provide good access with accessible toilets and car parking facilities, including spaces for those who are disabled.

The practice has a team of seven GPs meeting patients’ needs. Five GPs are partners meaning they hold managerial and financial responsibility for the practice. The practice employs one Nurse Practitioner, one Nurse Prescriber, two practice nurses and two healthcare assistants/phlebotomists. In addition there is a practice manager/partner, assistant practice manager, a team of medical administrators, secretaries, summarisers, prescribing clerks and receptionists.

Patients using the practice also have access to community staff including the community matron, district nurses, community psychiatric nurses, counsellors, support workers, on site ultra-sound scanning facility, health visitors and midwives.

The practice provides services to a diverse population age group, in a residential location. The practice provides GP cover for a 106 bed nursing home and provides two ward rounds twice a week.

The practice is a training practice, training medical students from Cambridge University.

Outside of practice opening hours a service is provided by another health care provider, by patients dialling the national 111 service.

Routine appointments are available daily and are bookable up to six weeks in advance. Urgent appointments are made available on the day and telephone consultations also take place. From 1 June 2015 the practice was moving its appointment system to a GP telephone triage service.

Updated 20 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Nene Valley Medical Practice on 19 May 2015. Overall the practice is rated as good.

We found the practice to be safe, effective, caring, responsive to people’s needs and well-led. The quality of care experienced by older people, by people with long term conditions and by families, children and young people was good. Working age people, those in vulnerable circumstances and people experiencing poor mental health also received good quality care.

Our key findings were as follows:

• The practice had a good understanding of the needs of the practice population and services were offered to meet these.

• Patients were satisfied with the service and felt they were treated with dignity, care and respect and involved in their care.

• There were systems in place to provide a safe, effective, caring and well run service. Practice staff were kind and caring and treated patients with dignity and respect.

• The practice was safe for both patients and staff. Robust procedures helped to identify risks and where improvements could be made.

• The clinical staff at the practice provided effective consultations, care and treatment in line with recommended guidance.

• Services provided met the needs of all population groups.

• The practice had strong visible leadership and staff were involved in the vision of providing high quality care and treatment.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Ensure staff have a clear understanding of the Mental Capacity Act and their role in implementing it.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 August 2015

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. 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 medication 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.

Updated 20 August 2015

The practice is rated as good for the population group of families, children and young people. Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us and we saw evidence that children and young people were treated in an age appropriate way and recognised as individuals. Appointments with GPs and nurses were available outside of school hours and the premises were suitable for children and babies. We were provided with good examples of joint working with midwives and community services. Antenatal care was referred in a timely way to external healthcare professionals. Parents we spoke with were positive about the services available to them and their families at the practice. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health.

Updated 20 August 2015

The practice is rated as good for the care of older people. It was responsive to their needs. Patients over 75 years of age had a named GP to ensure continuity of care for the elderly. The practice held 2.4% of its most vulnerable of admission, older patients on an ‘unplanned admissions’ register’. Home visits and priority appointments (including for patients who were receiving palliative care) were available and the practice aimed to call these patients back within 30 minutes of a home visit request or for any urgent medical problems. Practice audits showed the practice had achieved a 92% call back rate within 30 minutes for these patients with 94% of requests for home visits to older and vulnerable patients visited by a GP on the same day. The practice was actively promoting electronic prescribing (ETP2) and at the last practice audit had achieved 50% of its repeat prescriptions via ETP2. The practice provided cover for a 106 bed nursing home and provided two ward rounds twice a week and visited patients at the home when required. Multi-disciplinary team meetings took place for elderly patients with complex needs. External support was signposted and made available for them to access. Elderly patients had a named GP to receive continuity of care. Telephone consultations were available. The practice was pro-active and encouraged patients to receive flu and pneumococcal vaccinations.

Updated 20 August 2015

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. For example, the practice had introduced early morning and late evening extended hours appointments during the week and also Saturday morning appointments. 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 20 August 2015

The practice proactively identified patients who may be at risk of developing dementia. The practice were aware of the number of patients they had registered with dementia and additional support was offered. This included those with caring responsibilities. A register of dementia patients was being maintained and their condition regularly reviewed through the use of care plans. Patients were referred to specialists and then on-going monitoring of their condition took place when they were discharged back to their GP. Annual health checks took place with extended appointment times if required. Patients were signposted to support organisations such as the mental health charity MIND, Improving Access to Psychological Therapies (IAPT) and the community psychiatric nurse for provision of counselling and support. However not all staff had a clear understanding of the Mental Capacity Act and their role in implementing the Act.

Updated 20 August 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable those with learning disabilities. Annual health checks for people with learning disabilities were undertaken and patients received annual follow-ups. Double appointment times were offered to patients who were vulnerable or with learning disabilities. All patients were able to register at the practice as temporary residents, regardless of their personal circumstances, including the homeless and members of the travelling community.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice worked closely with The Carers Trust and in September 2014 was awarded ‘Practice of the Month’ for their work with carers. In particular the practice had worked closely with the trust to run drop in sessions for carers where they could come to the practice, have a cup of coffee or tea and speak to someone for support and advice. (The Carers Trust provide cover for carers to facilitate a short break or evening off and provide signposting for additional help and support). The practice manager told us there were no other services of this type in the area and the Carers Trust had recognised the practices innovation in working with them on this.

Staff knew how to recognise signs of abuse in vulnerable adults and children. A lead for safeguarding monitored those patients known to be at risk of abuse. All staff had been trained in safeguarding and were aware of the different types of abuse that could occur.