Archived: Norton Medical Practice

Updated 3 October 2016

Norton Medical Practice is a long established practice located in the Stourbridge area of the West Midlands. There are approximately 5800 patients of various ages registered and cared for at the practice. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. The practice has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients.

The clinical team includes two GP partners, a foundation doctor, a nurse prescriber, practice nurse and a health care assistant. Foundation doctors are fully qualified doctors who rotate around various specialties to increase their experience. The GP partners and the practice manager form the practice management team and they are supported by a team of eight staff members who cover secretarial, administration and reception duties. The practice was also an approved training practice and there is currently one GP in training at the practice.

The practice is open for appointments between 8am and 6:30pm during weekdays except for  Thursdays when the practice closes at 1pm. There are arrangements to ensure patients receive urgent medical assistance when the practice is closed, there is a GP on call every Thursday afternoon and there are arrangements to ensure patients receive medical assistance during the out-of-hours period.

Updated 3 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Norton Medical Practice on 4 August 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed with the exception of risks associated with legionella, the absence of emergency medical equipment that reflects national standards and staff undertaking duties without appropriate checks or risk assessments in place
• Recruitment checks were in place with the exception of a disclosure and barring check (DBS) for the practice healthcare assistant. The practice did not complete risk assessments to assess the risk of not having DBS checks for staff that chaperoned.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 regular multidisciplinary meetings and practice meetings. We found that nursing staff were not regularly included in the practice meetings and therefore information from audits, significant events and complaints were not always fed back to the nursing team.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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.

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

The areas where the provider must make improvements are:

• Ensure effective recruitment checks are in place under current legislation, including disclosure and barring checks (DBS) for all clinical staff.
• Ensure risk assessments are in place to assess the risk of not having disclosure and barring checks (DBS) for staff that chaperone.

In addition the provider should:

• Ensure key information from significant events, complaints and audits are shared consistently with all relevant staffing groups within the practice so that learning can be applied and shared across all areas.
• Assess and manage risks associated with legionella

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 October 2015

The practice is rated as good for the care of people with long-term conditions. Patients with long term conditions had a six monthly review with either the GP or the nurse to check that their health and medication needs were being met. Patients were encouraged to manage their conditions and were referred to other services for support with dietary advice, weight management and smoking cessation.

Updated 8 October 2015

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 who were at risk such as children and young people who had a high number of A&E attendances. The practice met with the health visitor on a weekly and monthly basis to discuss any safeguarding issues as well as those children who had long term conditions. Immunisation rates were in line with local and national averages for all standard childhood immunisations. Home visits and telephone consultations were offered to all new mothers within the first two weeks of birth.

Updated 8 October 2015

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 and offered home visits and rapid access appointments for those with enhanced needs. The practice had regular contact with district nurses and participated in weekly and monthly meetings with other healthcare professionals to discuss any concerns.

Updated 8 October 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). Results from the National GP Patient Survey from July 2015 showed that patient’s satisfaction with opening hours was below local and national averages. While comment cards contained positive comments regarding access to the service, one of them suggested that later appointments would be beneficial for the working population. The action plan from the patient satisfaction survey highlighted that the practice was looking to increase clinical appointments further. 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 8 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All patients experiencing poor mental health had received an annual physical health check. The practice 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.

Updated 8 October 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability. Staff had been trained 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. The practice was part of a pilot scheme in the area to help to provide social support to their patients who were living in vulnerable or isolated circumstances. Since the practice joined the pilot scheme in April 2015, they have started to identify patients who may be living in isolation and may feel lonely. These patients were seen by one of the GPs and referred to a service called Integrated Plus. The management team explained how referrals were done through their multi-disciplinary meetings. As the pilot was fairly new for the practice, success rates had not yet been measured. However, the practice explained how this service would be used to encourage patients on the scheme to connect with voluntary and community sector services.