Archived: Mill View Surgery

Updated 12 July 2017

Mill View Surgery is located in the rural village of Rocester, in East Staffordshire. The area has some pockets of deprivation although overall average levels are similar to the national average. There are low rates of unemployment when compared to national averages.

The practice was established 80 years ago and is situated in a purpose built building. The practice has a dispensary within the building that it owns. The building is on two storeys and has a lift although treatment rooms are currently on the ground floor. There is spare capacity to expand, and third party providers work from the premises, for example; a chiropody service and staff from the mental health community team currently use rooms within the building.

The practice has a list size of 2,000 patients. The population distribution shows higher than average number of patients over 65 years of age. The ethnicity data for the practice shows 98% of patients are white British. The practice population is static and the local population has remained static. However there are plans to build further housing.

The practice is a partnership with a GP and practice manager being the two partners. They are supported by locum GPs. The GPs work a combined number of sessions equivalent to 1.8 full time equivalent. The GPs are assisted by a clinical team consisting of a practice nurse and a healthcare assistant. The administration team consists of a practice manager partner and five administration staff. The dispensary is managed by a senior dispenser who is supported by the administration staff.

The practice opens from 8am to 6.30pm, Monday to Friday. Consulting times in the morning are from 9am to 10.30am and in the afternoon from 4pm and 5.30pm. However there are no clinics on a Thursday afternoon. The dispensary is open each week day between 9am and 1pm and in the afternoon between 3pm and 6pm. When the practice is closed patients are advised to call the NHS 111 service or 999 for life threatening emergencies. The practice has opted out of providing an out of hours service choosing instead to use a third party provider, Staffordshire Doctors Urgent Care. The nearest hospital with an A&E unit and a walk in service is Queen’s Hospital, Burton-upon-Trent. The nearest walk in centre is in Leek.

Updated 12 July 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Mill View Surgery on 27 April 2016. The overall rating for the practice was ‘Good’ with requires improvement for providing a safe service. The full comprehensive report on the 27 April 2016 inspection can be found by selecting the ‘all reports’ link for Mill View Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 13 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations identified at our previous inspection on 27 April 2016. This report covers our findings in relation to those requirements.

Our key findings were as follows:

• The practice had implemented systems to ensure that repeat prescribing was carried out in line with national guidance.
• A prescription tracking system had been introduced.
• Regular monitoring of the water system was carried out in accordance with the Legionella risk assessment.

At this inspection we found that the practice had addressed all the concerns raised and is now rated as good for providing well-led services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 June 2016

The practice is rated as good for the care of people with long-term conditions. The practice adopted a GP led, holistic approach to patients with long term conditions. Patients were assessed on their clinical needs and extra support offered if seen as beneficial. After initial diagnosis, patients (and sometimes their families) were invited in to talk about the condition, the effect on their life and how families could support them. A robust patient recall system ensured that patients were invited in for regular reviews. Patients were reviewed in GP and nurse led chronic disease management clinics. We found that the nursing staff had the knowledge, skills and competency to respond to the needs of patients with long-term conditions such as diabetes and asthma. Longer appointments and home visits were available when needed. Written management plans had been developed for patients with long-term conditions and those at risk of hospital admissions. For those people with the most complex needs, the GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care. The practice held a list of palliative patients and a GP partner acted as palliative care lead. The gold standards framework was used to provide the framework for end of life care.

Updated 22 June 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 who were at risk, for example, children and young people who had protection plans in place. Children who did not attend appointments were followed up or reported to the health visitor. Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children. There were screening and vaccination programmes in place and the practice indicators were comparable with the local Clinical Commissioning Group (CCG) averages. The practice worked with the health visiting team to encourage attendance. New mothers were offered post-natal checks and development checks for their babies.

Updated 22 June 2016

The practice is rated as good for the care of older people. Every patient over the age of 75 had a named GP and all hospital admissions were reviewed. This included patients that resided in nursing and care homes. 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, risk profiling and case management. All patients over the age of 75 who were identified as at risk of hospital admission had a completed care plan. The practice was responsive to the needs of older people and offered home visits and offered longer appointments as required. The practice had identified and supported patients who were also carers.

Updated 22 June 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. A range of on-line services were available, including medication requests, booking appointments and access to health medical records. The practice offered a health check with the nursing team to all patients aged between 40 and 75. The practice offered a full range of health promotion and screening that reflected the needs of this age group.

Updated 22 June 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients who presented with an acute mental health crisis were offered same day appointments. People experiencing poor mental health were offered an annual physical health check. Dementia screening was offered to patients identified in the at risk groups and the practice carried out advance care planning for patients with dementia. Practice staff had received training in dementia awareness.

The practice had regular meetings with other health professionals in the case management of patients with mental health needs.

The practice worked closely with the health visiting team to support mothers experiencing post-natal depression. It had told patients about how to access various support groups and voluntary organisations and signposted patients to support groups where appropriate.

Updated 22 June 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. We found that the practice enabled all patients to access their GP services and assisted those with hearing and sight difficulties. A translation service was available for non-English speaking patients. The building had automated entrance doors and a disabled toilet.

The practice held a register of patients with a learning disability and had developed individual care plans for each patient. Out of seven patients on the learning disabilities register, four had received annual health checks in the preceding 12 months and two had declined and one relocated. Longer appointments were offered for patients with a learning disability and carers were encouraged by GPs to be involved with care planning. The GPs regularly performed ward rounds at a local care home for patients with learning disabilities.

The practice had a register of vulnerable patients and displayed information about how to access various support groups and voluntary organisations. For example, there were posters for a local substance misuse support service. 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.