The Medical Centre

Updated 16 January 2017

The Medical Centre occupies a purpose-built property in Victoria Road, Barnetby, North Lincolnshire DN38 6HZ. The practice has a General Medical Services (GMS) contract and is authorised to dispense drugs.

There are 2964 patients on the practice list and the majority of patients are of white British background. The proportion of the practice population in the 40-69 years age group is slightly higher than the England average. The practice scored eight on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

The practice has one male GP. There are three practice nurses and a health care assistant. There is a practice manager, two administrators, medical secretary, dispensary manager, two dispensary assistants and three receptionists.

The practice was open between 8am and 6pm Monday to Friday. Appointments were from 8am to 11am every morning and 3pm to 5.50pm daily.

In addition to pre-bookable appointments that could be made in advance, urgent appointments were also available for people that needed them.

When the practice is closed, patients are directed to NHS 111. The Out Of Hours service is provided at a GP Emergency Centre. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

Updated 16 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Medical Centre on 26 October 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 to report incidents and near misses. However, when things went wrong, the learning from reviews and investigations was not always embedded.

• Risks to patients were generally assessed and well managed, with the exception of those relating to employment checks undertaken. 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.
• 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 and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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 practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example appropriate recruitment checks on staff had not been undertaken prior to their employment and security of medicines required improvement.

The areas where the provider should make improvement are:

• Ensure recruitment procedure and policy is followed and arrangements include all necessary employment checks for all staff.
• Thoroughly investigate all complaints and significant events to ensure learning opportunities are maximised.
• Review the frequency of basic life support training to ensure it follows best practice guidelines as laid down by the Resuscitation Council (UK).
• Undertake ongoing assessments of the competency of dispensary staff.
• Implement a comprehensive business continuity plan.
• Undertake DBS checks for the volunteer drivers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 January 2017

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was 95%. This was above the CCG average of 90% and the national average of 89%.
• Longer appointments and home visits were available when needed.
• 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.

Updated 16 January 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. Immunisation rates were relatively high for all standard childhood immunisations.
• 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.
• Uptake for the cervical screening programme was 90% which was better than the CCG average of 77% and the national average of 74%.
• Congratulation cards were sent following births.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 16 January 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Patients over 75 years are given 20 minute appointments.

Updated 16 January 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, flexible and offered continuity of care.
• 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 16 January 2017

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

• 83% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the CCG average of 81% and the national average of 84%.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015). This was similar to the CCG average of 86% and the national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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 16 January 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 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.