Archived: GeneralMedicalServices Ltd Also known as Five Towns GP Surgery

Updated 7 September 2016

GeneralMedicalServices Ltd (Five Towns GP Surgery) is a registered with the Care Quality Commission as an organisation provider.

The provider has two GP practices within Stoke on Trent, our inspection focussed on the services provided at Five Towns GP Surgery in Shelton Primary Care Centre.

The practice demographic is not representative of the national averages for a GP practice in a number of areas, including:

• 83% of patients are aged less than 45 years of age compared with the clinical commissioning group (CCG) average of 57% and national average of 58%.

• 80% of patients are from black or minority ethnic origin compared with the CCG average of 10% and national average of 16%.

• Deprivation in the area is higher than both national and local averages. This factor is known to increase the demand on a GP practice

The practice has evolved as it was initially run by a legacy out-of-hours GP provider. The existing provider began to provide services under an Alternative Medical Provider Services contract with NHS England at the premises in July 2011. Since July 2011, the patient list size at the practice has increased by over 50%. At the time of our inspection the practice had 3,745 registered patients.

The practice is open on Monday, to Friday from 8am to 6:30pm. During these times telephone lines and the reception desk are staffed and remain open. Extended hours appointments are offered on a Monday until 7:30pm. When the practice is closed patients can access help by telephoning the practice, after which their call is transferred to the NHS 111 service for assistance. The practice has opted out of providing out-of-hours services to their patients, these services are provided by Staffordshire Doctors Urgent Care.

Staffing at the practice includes:

• Five GPs (four male, one female) of which two work full time and three work part time.

• A female nurse practitioner and healthcare support worker/admission avoidance facilitator.

• A practice manager, assistant practice manager and four reception/administrative staff.

Updated 7 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at GeneralMedicalServices Ltd (Five Towns GP Surgery) on 29 June 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• 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.
• Most 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.

We saw an area of outstanding practice:

The practice reached out to the local community to provide information on living healthier lifestyles. For example:

• The practice was sensitive to the cultural needs of patients. Information was provided on how to manage diabetes during Ramadan. They also raised awareness of how to minimise the emergence of Vitamin D deficiency whilst remaining respectful to cultural belief and practise.

• Annual health events for the community were arranged during Eid. The practice and PPG arranged events which were open to the whole community. Information and advice was provided on topics such as the methods and importance of breast screening, blood pressure and body mass index checks. The event identified patients that required further assessment which included patients that did not receive their individual care at the practice.

• The advanced nurse practitioner provided asthma information sessions to children at two local primary schools. The importance of having individual asthma plans in place in the school setting was discussed with the teaching staff. This was part of a wider practice initiative to improve the outcomes of patients with asthma.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 September 2016

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.

• The practice was taking action to improve the outcomes for patients with asthma. This was by providing self-management plans and high levels of community education.

• 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 7 September 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 relatively high for all standard childhood immunisations.

• The advanced nurse practitioner provided asthma information sessions to children at two local primary schools. The importance of having individual asthma plans in place in the school setting was discussed with the teaching staff. This was part of a wider practice initiative to improve the outcomes of patients with asthma.

• The practice offered appointments to suit patients in this group. This included evening appointments and after school hours.

• All children aged 12 and under with were given same day access to a clinician.

Updated 7 September 2016

The practice is rated as good for the care of older people.

• The practice had a lower than average number of patients in this age group.

• The practice was responsive to the needs of older people, and offered yearly health checks to all those aged 75 and over.

• Patients in this group who had not attended the practice within six months were contacted to establish their well-being.

Updated 7 September 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.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

Updated 7 September 2016

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

• Performance for poor mental health indicators was higher than local and national averages. For example, 96% of patients with enduring poor mental health had a recent comprehensive care plan in place compared with the CCG average of 86% and national average of 88%.

• Staff had received awareness training and had become Dementia Friends. A Dementia Friend learns a little bit more about what it's like to live with dementia and then turns that understanding into action

• Practice staff were aware of the population demographic and actively screened for symptoms in those at higher risk of poor mental health.

• 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 7 September 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 25 with a learning disability. All patients with a learning disability had received an annual health assessment.

• 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.