The Medical Centre

Updated 28 December 2022

Frances Street Medical Centre is located in Doncaster at:

The Medical Centre

2 Frances Street

Doncaster

DN1 1JS

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, treatment of disease, disorder or injury and surgical procedures.

The practice is situated within South Yorkshire Integrated Care System (known as NHS South Yorkshire) and delivers Personal Medical Services (PMS) to a patient population of about 7,048. This is part of a contract held with NHS England.

The practice is part of Central Primary Care Network which consists of six member practices with a total patient population of over 68,929.

Information published by Public Health England shows that deprivation within the practice population group is in the second lowest decile (two of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 6.3% Asian, 89.5% White, 1.6% Black, 1.7% Mixed, and 1% Other.

The age distribution of the practice population closely mirrors the local and national averages. There are more male patients registered at the practice compared to females.

There is a team of two GPs. The practice has an advanced nurse practitioner, a trainee nurse associate and three nurses who provide nurse led clinics for long-term conditions. The GPs are supported at the practice by a team of reception/administration staff, one physician’s associate, a pharmacy technician and a practice manager to provide managerial oversight.

The practice is open between 7.30 am to 6.00 pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally by Doncaster Same Day Health, where late evening and weekend appointments are available. Out of hours services are provided by NHS Doncaster.

Updated 28 December 2022

We carried out an announced inspection at Frances Medical Centre (or the Medical Centre as it is known locally) on 8 and 9 November 2022 Overall, the practice is rated as Good.

Safe - Good

Effective – Requires Improvement

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 6 April 2016 the practice was rated Outstanding overall and for responsive and well- led services and good for safe, effective and caring services.

At the last inspection, we rated the practice as outstanding for providing responsive and well-led services because:

• The practice referred to the nurse who reviewed patients in their own home as the 'iNurse using video chat technology to perform joint consultations with the GP.
• The practice had liaised with the local bail hostel whereby residents were supported to access health care at the practice within a safe environment.
• The practice employed a clinical pharmacist who supported staff at the practice through review of medicines prescribed, promoting best practice and providing advice for prescribing.
• The patient participation group liaised with staff to schedule a regular a programme of patient engagement events where practice staff and external speakers facilitated educational events for patients and people from the local community.

At this inspection, we found that those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. While the provider had maintained this good practice, the threshold to achieve an outstanding rating had not been reached. We also found, areas of concern in effective following a clinical review of some patient records. There was a lack of consistency in the effectiveness of the care, treatment and support people with long term conditions received.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Frances Medical Centre on our website at www.cqc.org.uk.

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• Reviewing staff feedback forms.
• Reviewing PPG feedback forms.
• Speaking with patients.
• A short site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• There was a lack of consistency in the effectiveness of the care, treatment and support people with long term conditions received.
• The service had a high turnover of transient patients which effected their national prevention and survey data outcomes. However, despite data being lower than national averages in some areas, the provider had implemented systems and had adapted services to meet the needs of its population groups.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.

The practice had gone to significant efforts to respond to the needs of some of the most vulnerable individuals in the city to support them to access health and social care.

• The continuing development of the staff’s skills and knowledge was recognised as being integral to ensuring high quality care.

We saw some ares of outstanding practice, for example:

• The practice was proactive in providing care and treatment to hard to reach and vulnerable patients such as asylum seekers, homeless people, people whose first language was not English and residents of bail hostels.

Whilst we found no breaches of regulations, the provider should:

• Continue with plan to minute safeguarding meetings for future reference.
• Implement plan for monitoring of medication reviews.
• Check ReSPECT forms are scanned on to the patients record.
• Review historic safety alerts and take steps to ensure all necessary actions are taken.
• Implement and embed systems for monitoring the effectiveness of the care, treatment and support people with long term conditions receive.
• Continue with the plan to document non-prescribers’ supervisions.
• Continue to improve uptake of national screening programmes.
• Advise complainants of their right to escalate their concerns to the Parliamentary and Health Service Ombudsman.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services