Musters Medical Practice

Updated 24 December 2015

Musters Medical Practice provides primary medical services to approximately 8953 patients through a personal medical services contract (PMS). Services are provided to patients from a purpose built primary care centre. The practice is co-located with another local practice.

The practice population live in an area of below average deprivation. Income deprivation affecting children and older people is below the national average.

The practice team is comprised of four GP partners, a nurse practitioner, three practice nurses and a health care assistant. The practice is an accredited training practice and at the time of the inspection the practice had three GP registrars (GP registrars are qualified doctors who are training to become GPs through a period of working and training in a practice) working within the practice.

The clinical team is supported by a practice manager and ten reception and secretarial staff.

The practice opens from 8.00am to 6.30pm Monday to Friday. Morning appointments are available daily from 8.30am to 11.30am. Afternoon appointments are available from 4.00pm to 6.00pm Monday, Wednesday and Friday and from 4.00pm to 7.30pm on Tuesday and Thursday.

The practice has opted out of providing out-of-hours services to its patients. This service is provided by Nottingham Emergency Medical Service (NEMS). As part of the Prime Minister’s Challenge Fund, the practice participated in offering a Saturday and Sunday morning service for urgent GP consultations in a local surgery.

Updated 24 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Musters Medical Practice on 8 September 2015. Overall the practice is rated as good.

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

• The practice had arrangements in place to deal with information concerning safety. Staff were aware of their responsibilities to raise concerns and report incidents. Information relating to safety was documents, monitored and reviewed.

• Most risks to patients were assessed and well managed, however, the practice needed to ensure oversight of risks related to areas of the building which it occupied.
• The practice used best practice guidance to plan and deliver treatment for its patients. staff had received training appropriate to their roles and were able to access further training to meet their training needs.
• Patients told us they were treated with dignity and respect and involved in decisions about their care. Staff treated patients and families with compassion.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had very good facilities and was well equipped to treat patients and meet their needs.
• There was clear leadership within the practice and we saw evidence of a very supportive culture amongst practice staff. The practice encouraged feedback and suggestions from staff.

However there were some areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure formal arrangements are in place to identity, assess and manage all risks for those areas of the building that occupied and used by the practice
• Ensure there are robust systems in place for the storage of staff appraisal documentation
• Ensure that staff undertaking chaperone duties have a clear understanding of their role and responsibilities
• Ensure that their business continuity plan is updated to reflect current contact details for relevant organisations
• Ensure that oral airways and masks identified on inspection as being in poor condition are replaced

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 December 2015

The practice is rated as good for the care of people with long-term conditions. Nursing and medical staff had lead roles in the management of chronic diseases.

Staff demonstrated that they had the knowledge and skills required to respond to the needs of patients with long-term conditions and had received additional training in these areas. For example in relation to chronic obstructive pulmonary disease (COPD). (COPD is the name for a collection of lung diseases).

Longer appointments and home visits were available for these patients as required and all of these patients had a named GP. Appointments for those who attended the surgery were offered on flexible times and days.

The practice demonstrated a multidisciplinary approach to the care of these patients.

Updated 24 December 2015

The practice is rated as good for the care of families, children and young people.

There was a named safeguarding lead at the practice. The staff we spoke with demonstrated knowledge and understanding in relation to safeguarding children and were aware of their responsibilities to report concerns. The practice held regular meetings to discuss children at risk. Feedback from the health visitor was positive regarding the practice.

Flexible appointment times were offered for mothers at the beginning and end of the day to help them plan their day around other commitments such as taking children to school. The practice had consistently achieved relatively high rates for childhood immunisations.

The practice offered baby changing facilities and an area where mothers could breastfeed should they not wish to do this in the main waiting area.

Updated 24 December 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice had links to local care homes where it offered weekly and fortnightly scheduled visits to proactively deal with patient needs. Feedback from care homes served by the practice was extremely positive.

The practice held monthly multidisciplinary meetings to ensure that older patients at high risk of hospital admission were reviewed and had care plans in place.

Updated 24 December 2015

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 reflected the needs for this age group. The practice used a text messaging service to remind patients of appointment bookings.

The practice opened two evenings per week until 7.30pm and supported weekend opening at a local surgery to facilitate access for working age patient.

The practice offered contraception services including coil fitting, coil checks and sexual health services. The practice also participated in delivering weekend morning GP services at a local health centre.

Updated 24 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice conducted regular ward rounds of local care homes who had residents with dementia. Feedback about the practice from care home staff was wholly positive.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 24 December 2015

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 carers and those with a learning disability. It had carried out annual health checks for people with a learning disability and offered longer appointments for these patients.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.

The practice worked with a local carers’ charity to offer sessions with a support worker at the practice for people with a caring responsibility. The practice had also appointed a carers’ champion to aid with identifying carers and ensuring that the appropriate support was in place for these patients.