Ivry Street Medical Practice

Updated 10 April 2017

The practice is situated in and covers the area of Ipswich and the villages of Bramford, Claydon, Barham, Westerfield, Tuddenham, Witnesham, Rushmere St Andrew and Kesgrave. The practice operates from a large four storey building and offers health care services to 11,300 patients. They offer consultation space for GPs, nurses and attached professionals including midwives, physiotherapists, and a community minor surgery unit.

The practice holds a GMS contract, which is commissioned by NHS England. A GMS contract is a nationally negotiated contract to provide care to patients and is a training practice with two GP trainers. A training practice has trainee GPs working in the practice; a trainee GP is a qualified doctor who is undertaking further training to become a GP. A trainer is a GP who is qualified to teach, support, and assess trainee GPs. There is one trainee GP working in the practice.

• There are five[CT1] GP partners and one salaried GP at the practice (three female and three male GPs). There are also four practice nurses (three hold independent prescribing qualifications), and one healthcare assistant and one phlebotomist.

• A team of 15 administration and reception staff support the practice manager and the unit manager.

• The practice is open between 8am and 8pm Mondays and 8am to 6.30pm on Tuesday to Friday. The practice offers pre booked appointments on Saturdays 8.30am to 11am.

• If the practice is closed, patients are asked to call the NHS111 service or to dial 999 in the event of a life threatening emergency.

• The practice profile for age range of patients is comparable to the national average. The deprivation score is below the England average. Unemployment in the practice population is lower than the England average, the percentage of patients who provide unpaid care is in line with the national average.

• Male and female life expectancy in this area is in line with the England average at 79 years for men and 83 years for women.

Updated 10 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ivry Street Medical Practice on 13 July 2016. The overall rating for the practice was good, with requires improvement for the safe domain. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Ivry Street Medical Practice on our website at www.cqc.org.uk.

We visited Ivry Street Medical Practice to conduct a follow-up focused inspection to check that they had followed their plan and to confirm that improvements had been made following our previous inspection on 13 July 2016. This report only covers our findings in relation to those requirements. Overall the practice is now rated as good.

However, on the inspection on 13 July 2016, there were areas of practice where the provider needed to make improvements.

We found that the provider must ensure that the actions required in the fire risk assessment are completed and that the practice conducts regular fire drill training. Ensure that ‘safe rooms’ to be used by patients who are unable to manage the stairs in the event of a fire are clear and that plans are available to inform staff and emergency services where they are located.

In addition, we found that the provider should review the infection control procedures within the practice and ensure that sufficient time is allocated to the lead. Review the cleaning schedules and have formal systems in place to monitor the contract cleaners. Review the system used to manage safety alerts. Continue to improve and embed accurate recording/coding of patient data to ensure effective and safe care of patients. Undertake a risk assessment of the use of mercury sphygmomanometers and ensure that mercury spillage kits are available. Review the system used to record and monitor the use of prescription pads and forms. Improve the system to ensure the management team have oversight of the training that practice staff have undertaken and any training that is due.

At this inspection we found evidence that the practice had a completed fire risk assessment and had completed the actions identified. They had carried out a fire drill in August 2016, with another planned for May 2017. Both ‘safe rooms’ were clear and staff were able to demonstrate how they would inform emergency services where they were located in the event of a fire.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 August 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 patients at risk of hospital admission were identified as a priority.

• Longer appointments and home visits were available when needed this included for patients with a learning disability that lived in care homes.

• 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.

Updated 9 August 2016

The practice is rated as good for the care of families, children, and young 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 people who had a high number of A&E attendances. Immunisation rates were in line with the national averages for all standard childhood immunisations.

• Patients told us that children and young people 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.

• We saw positive examples of joint working with midwives, health visitors, and school nurses.

Updated 9 August 2016

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

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

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

• The practice proactively cared for patients who lived in care homes and undertook regularly visits.

• Home visits were available for patients who needed them.

Updated 9 August 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 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.

• The practice offered appointments on Monday evenings and on Saturday mornings enabling patients that could not attend during the weekdays to access appointments.

Updated 9 August 2016

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

• The practice had 90 patients diagnosed with dementia on the register. 68% of these patients had received an annual review. Many of the remaining 32% lived in care homes and had GP reviews throughout the year. The reviews included advance care planning.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice had told patients experiencing poor mental health 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 where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia. GPs demonstrated that they manged complex patients with care plans and continuity of care.

Updated 9 August 2016

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

• There was a lead GP and the practice held a register of patients living in vulnerable circumstances including homeless people, travellers, and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

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

• Practice staff had received training and 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.