Archived: The Grove Medical Practice

Updated 22 July 2016

The Grove Medical Practice is a town centre practice providing care for approximately 4,700 patients over three sites in the Barnsley Clinical Commissioning Group (CCG) area. There are two branch sites, one at 113 - 115 Sheffield Road, Birdwell, Barnsley, South Yorkshire S70 5TA and the other at Cliffe Road, Brampton, Rotherham S73 0XP.

The practice is made up of two former practices, the main site and one branch was run by a single handed GP for 42 years until 2010, the other branch was formally a practice run by a single handed GP for 38 years until January 2014. 

The Grove Medical Practice had recently taken over a third practice which they run with the same staff but at the moment it has a separate patient group. They are hoping to merge this practice with The Grove Medical Practice as a third branch surgery to further benefit the patients by improving access across four sites across the town. The two branch surgeries were formally separate practices and have been merged with The Grove Medical Practice within the last two years.

The practice catchment area has been identified as one of the third most deprived areas nationally. It provides services from a converted large house, with disabled access and on street parking. The building is reasonably well planned and is over 3 floors with no lift although patients with mobility issues can be seen on the ground floor.

The Grove Medical Practice has two GP partners, one male, one female and one male salaried GP (3 WTE GPs), four female nurses (including two advanced nurse practitioners) and two healthcare assistants.

There is a hearing loop and the practice is working with BSL signers to provide a service for the deaf.

The practice and the two branch surgeries are open from 8am to 6.30pm Monday to Friday. Extended hours appointments with GPs and nurses are offered on a Monday until 8pm and Tuesdays and Wednesdays until 7pm. Appointments are offered throughout the day at the three locations. Patients could also request a same day telephone call back from the doctor if required for advice.

Out of hours services are accessed by calling the practice telephone number or NHS 111.

Updated 22 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Grove Medical Centre on 23 May 2016. 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. There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. All opportunities for learning from internal and external incidents were maximised.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice was approached by other providers in the area to take over their practices following retirement.

• Feedback from patients about their care was consistently positive. Several patients told us that the GPs would often call in on housebound patients and those with palliative care needs, without being asked. When the other practices were merged, staff took time and effort to engage with patients to provide a service tailored to the needs of each site.

• Risks to patients were assessed and well managed.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, to maintain consistency with long term condition management across town boundaries, the Advanced Nurse Practitioners would undertake long term condition reviews for housebound patients where required.

• 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.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw areas of outstanding practice including:

• Several patients told us that the GPs would often call in on housebound patients and those with palliative care needs, without being asked.
• The practice had developed its own easy to read leaflet which clearly explained to parents and carers how and when they should seek urgent medical help with an unwell child. There was a policy displayed and promoted, stating that all unwell children would be seen on the day.
• We saw evidence of teamwork within the practice with adult safeguarding and a close working relationship with outside agencies such as the adult safeguarding team and the local authority. We saw examples of where GPs had gone out of their way and beyond usual duties to ensure patients were safe and protected. We observed evidence of this.
• Staff told us there was a commitment to development and training in any areas that might benefit patients. All staff were learning British Sign Language (BSL) to be more welcoming and inclusive for a family of patients who used BSL to communicate.
• Ability to listen to the Patient Participation Group (PPG) and act on patient feedback was excellent.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice

Updated 22 July 2016

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

• Practice nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.

• Clinical meetings are held monthly to discuss performance in long term condition management.

• All patients with a long term condition were reviewed following hospital admission to assess and advise how admission may be avoided in the future.

• Performance for diabetes related indicators at 90% was higher than the CCG average of 85% and equal to the national average of 90%.

• Until the practice merged in 2014, one of the branches had never had a recall system for patients with long term conditions. This has been put in place and patients requiring annual reviews have been invited to attend the surgery or reviewed opportunistically when attending for other reasons.

• Longer appointments and home visits were available when needed.

• Patients who were diagnosed with multiple long term conditions had their care reviewed in a single appointment at the site of their choice.

• To improve consistency for patients living across boundaries in the Rotherham and Barnsley CCG areas, it was decided that one of the Advanced Nurse Practitioners would undertake long term condition reviews for housebound patients where required.

• 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. The multidisciplinary teams met monthly and all meetings were minuted.

• Education sessions had been set up monthly to improve self care and empower patients to manage long term conditions along with support from the practice. These were advertised on the practice website and leaflets in the practice. Patients were being asked what they would like included in future sessions.

Updated 22 July 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 high for all standard childhood immunisations, for example, immunisation rates for children under the age of two were 98% to 100% (The national average was 96% to 98%). Staff offered immunisation opportunistically and had a dedicated member of the administration team who dealt with all recall letters and child immunisation administration.

• 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.

• In the last 5 years 78% of women aged between 25 and 60 years have received a cervical screening test which is comparable to the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• Lunchtime appointments were made available after a patient survey suggested that parents and carers would find it easier to attend the practice when their children were at nursery or school.

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

• The practice had developed its own leaflet which clearly explained to parents and carers how and when they should seek urgent medical help with an unwell child.

• There was a policy, displayed and promoted, that all unwell children would be seen on the day.

Updated 22 July 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.

• There was a housebound patient protocol and the practice was part of a locality nursing home patient review scheme.

Updated 22 July 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.

• Lunchtime appointments were offered following an in house patient survey.

• Telephone consultations with a GP 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 22 July 2016

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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 had their care reviewed in a face to face meeting in the last 12 months, which is below the CCG average of 81% and the national average national average of 84%.

• Performance in mental health indicators at 88% was above the CCG average of 83% and below the national average of 93%.

• The practice had a close working relationship with a consultant psychiatrist who would offer support to the GPs.

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

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

• Patients experiencing poor mental health were advised how to access various support groups and voluntary organisations.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT) to support patients’ needs.

• 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.

Updated 22 July 2016

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 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.

• 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.

• We saw evidence of teamwork within the practice with adult safeguarding and a close working relationship with outside agencies such as the adult safeguarding team and the local authority.

• Several patients told us that the GPs would often call in on housebound patients and those with palliative care needs, without being asked.