The County Practice

Updated 1 March 2017

The County Practice is a four partner practice supported by a two salaried GP which provides primary care services to approximately 11900 under a General Medical Services (GMS) contract.

• The practice is situated close to public transport and has parking facilities, including disabled bays. The car park is pay on foot as it is close to the town centre however there is also parking on the street.

• Services are provided from Syston Health Centre, 1330 Melton Road,Syston, Leicester, LE7 2EQ.

• The practice consists of four GP partners (Two male and two female) and two salaried GPs (Male and female).

• The all female nursing team consists of three practice nurses and three health care assistants (HCAs).

• The practice has a practice manager and assistant manager who are supported by an IT manager and senior receptionist. There are 12 clerical and administrative staff to support the day to day running of the practice.

• When the practice is closed patients are able to use the NHS 111 out of hour’s service.

• The practice has low deprivation and sits in the ninth least deprived centile.

• The practice is registered to provide the following regulated activities; surgical procedures; diagnostic and screening procedures, family planning; maternity and midwifery services; and treatment of disease, disorder or injury.

• The practice is an approved training practice for trainee doctors, registrars and medical students.

• The practice lies within the NHS East Leicestershire and Rutland Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

• The practice is open between 8.30am and 6pm Monday to Friday. There prebookable extended hours appointments Monday and Friday 7.30am to 8am and Tuesday 6.30pm to 7.30pm.

Updated 1 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The County Practice on 17 January 2017. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Lessons were shared to make sure action was taken to improve safety in the practice.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Patient survey figures showed patients rated the practice higher than others for most aspects of care. Comments about the practice and staff were positive.

• 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. Improvements were made to the quality of care as a result of complaints.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

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

• The provider was aware of and complied with the requirements of the duty of candour.

• Safety alerts and alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and cascaded to the appropriate persons.

• The practice had a number of policies and procedures to govern activity and held regular meetings. However the practice did not always update action plans and documents such as risk assessments to say they had been completed.

• The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

• The practice had identified 70 patients as carers (0.6% of the practice list).

The areas where the provider should make improvement are:

• Review process and methods for identification of carers and the system for recording this. To enable support and advice to be offered to those that require it.

• Update action plans accordingly to evidence completed actions

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 March 2017

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

• Staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The practice had nurse led chronic disease appointments for routine reviews

• Performance for diabetes related indicators was comparable to CCG and national averages. (93% compared to 93% CCG average and 90% national average).
• Longer appointments and home visits were available when needed.
• The practice worked with community specialist nurses for heart failure, complex diabetic patients and chronic obstructive pulmonary disease patients.

Updated 1 March 2017

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.

• The practice had an effective immunisation service and non-attenders were followed up.

• 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.

• The practice’s uptake for the cervical screening programme was 83%, which was comparable to the CCG average and national average of 82%.

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

Updated 1 March 2017

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.

• Patients had a named accountable GP to enable continuity of care.

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

• Reviews were completed in patients home were required.

• The practice worked with the multi-disciplinary teams in the care of older vulnerable patients. This included a pilot scheme to incorporate an Integrated Care Coordinator to allow referrals and support from a social services perspective.

Updated 1 March 2017

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 and flexible.

• Appointments were available on Monday and Friday 7.30am to 8am and Tuesday 6.30pm to 7.30pm.

• Telephone consultations 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 1 March 2017

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

• 74% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was below the CCG average of 81% and the national average of 84%.

• 100% of patients experiencing poor mental health were involved in developing their care plan in last 12 months which was better than the national average of 89%.

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

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Staff had a good understanding of how to support patients with mental health needs and dementia. Staff had completed dementia awareness training.

Updated 1 March 2017

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.

• The register was monitored to ensure patients were attending for their annual reviews.

• The practice offered longer appointments for patients with a learning disability with a named nurse to enable continuity of care for reviews.

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

• Staff 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.