Archived: Cromer Group Practice

Updated 12 November 2015

Cromer Group Practice is a well-established GP surgery that has operated in the area for over 30 years. It serves approximately 13000 registered patients and has a general medical services contract with North Norfolk Clinical Commissioning Group (CCG). The practice’s population rises sharply every summer with almost 1000 additional patients registering temporarily, whilst holidaying in the locality.

It provides medical services to a large number of care homes in the local area, and operates a dispensary. Compared with other practices nationally, it has a higher proportion of patients aged 60 years and above (31% of its total population group), and a lower proportion of patients 0-40 years.

The practice consists of five GP partners, four nurse practitioners, three nurses and three health care assistants. They are supported by a full time business and operations managers, and a number of reception and administrative staff. It is a training practice and offers placements to qualified doctors wanting to become GPs and medical students. It also offers placements to trainee nurses and pharmacists.

The practice is open between 8.30am and 6 pm Monday to Friday. It closes on a Tuesday between 1pm and 2 pm for staff training. Doctors consulting hours are Monday to Friday 9 am to 12 noon, and 2pm to 5.30pm. It does not provide extended hours opening.

Updated 12 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cromer Group Practice on 23 September 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• The practice undertook a wide range of both clinical and non clinical audits to drive improvements in patient care.

• The practice was actively involved in local and national initiatives to enhance the care offered to patients. They were proactive in trialling new ways of working to ensure they continued to meet the needs of the patients.

• 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 (PPG). Information about how to complain was available and easy to understand.

• There was a structured system for providing staff in all roles with annual appraisals of their work and planning their training needs.

• The practice was committed to primary care development and education. They took an active part in GP education and primary care research

• There was a clear leadership structure and staff felt supported by management.

We saw several areas of outstanding practice including:

• The practice provided a daily ‘ward round’ to a local nursing home. This service was greatly valued by both staff and residents at the home. Evidence from the clinical commissioning group showed that this had reduced the number of hospital admissions and referrals from the home as a result.

• In response to a complaint about the lack of information for bereaved patients, the practice had devised its own support leaflet , ‘Coping with bereavement’ which had been taken up by the CCG and shared for use by other local practices.

However there were areas of practice where the provider should make improvements:

• The practice should appoint leads for safeguarding, infection control and mental capacity and ensure these staff receive training at an appropriate level

• The practice should undertake an assessment of the risks in not carrying emergency medicines on patient home visits.

• The practice should ensure that all staff who undertake chaperone duties receive appropriate and effective training for this role. A risk assessment should also be completed if staff do not have a disclosure and barring check (DBS) in place, and are undertaking chaperone duties.
• The practice should assure themselves that any locum GPs recruited from an agency have the appropriate DBS checks in place.
• All treatment rooms should have privacy curtains around examination couches.
• The practice should restrict access to the dispensary to authorised staff only and implement measures to track prescription forms in accordance with national guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 November 2015

The practice is rated as good for the care of people with long-term conditions. The practice met all performance targets in relation to the management of long term conditions and offered specialist respiratory and anti-coagulation therapy clinics to patients. All patients had a named GP and a structured annual review to check that their health and medication needs were being met.

The practice’s clinicians provided a daily ‘ward round’ to a local 18-bedded health care unit.

Updated 12 November 2015

The practice is rated as good for the care of families, children and young people. Immunisation rates were relatively high for all standard childhood immunisations. Local midwives held weekly clinics at the practice and patients had post natal appointments with the GPs, All children who registered with the practice were referred to the health visitor. The practice offered contraceptive advice and implants.

The practice had recently extended the time for its immunisation clinics to allow extra time for its nurses to advise parents.

Updated 12 November 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The practice ran proactive vaccination campaigns and catch up programmes for shingles and pneumonia immunisation, along with an annual flu campaign.

The practice’s clinicians provided a daily ‘ward round’ to a large local nursing home .

Updated 12 November 2015

The practice is rated as requires improvement for the care of working-age people (including those recently retired and students). 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. However it did not provide any extended opening hours.

Updated 12 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice offered enhanced services for patients with mental health concerns and those with dementia. It 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.

It had recently worked closely with the clinical commissioning group to improve communication between health care services about patients with a diagnoses of dementia.

Updated 12 November 2015

The practice is rated as good for the care of people whose circumstances might make them vulnerable. The practice held a register of patients living in vulnerable circumstances including carers and those with a learning disability, and carried out annual health checks for people with a learning disability.

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