Archived: Iridium Medical Practice

Updated 10 September 2015

Iridium Medical Practice is a registered provider of primary medical services with the Care Quality Commission (CQC). The practice was a partnership of two GPs. However, during the last 12 months one of the GP partner had left and three other partners had joined. The practice manager who was the registered manager had recently left the practice. The practice was in the process of submitting appropriate forms so that the changes were reflected on CQC records.

The surgery served a population of approximately 13285 patients. The practice is open Monday to Friday 8am to 6.30pm. Extended opening was provided on Monday and Fridays from 6.30pm to 8.30pm. The practice has opted out of providing out-of-hours services to their own patients. This is provided by an external out-of-hours service contracted by the CCG.

Clinical staff included five GPs, this included four partners and one salaried GP (four male and one female). The nursing team included two advanced nurse practitioners who were qualified to diagnose medical problems, offer treatments, perform advanced procedures, prescribe medications, and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. There were also two nurse practitioners and three healthcare assistants. The administration team included a business manager, clinical excellence manager, who had been recruited very recently, an operations manager and a team of reception staff.

The practice holds a General Medical Services contract with NHS England and has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients.

Updated 10 September 2015

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Iridium Medical Practice on 19 May 2015. We have rated this practice overall as good.

Specifically, we found the to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, and people experiencing poor mental health (including people with dementia).

Our key findings were as follows:

• The practice had a system for reporting, recording and monitoring significant events over time to keep patients, staff and visitors safe. However, we found an emergency medicine that was out of date.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice was clean and hygienic with good facilities and was well equipped to treat patients and meet their needs.
• The practice had appropriate skill mix of staff with expertise and experience in a range of health conditions.
• The practice was proactive in helping people with long term conditions to manage their health and had arrangements in place to make sure their health was monitored regularly.
• Information about how to complain was available and easy to understand.
• We found that the service was well led with policies and procedures in place to support the running of the practice.

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

The provider should:

• Ensure all emergency medicines are in date and safe to use.
• Ensure infection prevention and control policy reflects the lead staff member.
• Ensure systems are in place to monitor if cleaning is being done by cleaners according to the practices cleaning schedules.
• Obtain details of legionella testing from the landlord and ensure any actions identified are followed.
• Consider if the Automated External Defibrillator (AED) shared within the building by other services would be immediately available in the event of an emergency. An AED is a portable electronic device that analyses life threatening irregularities of the heart including ventricular fibrillation and is able to deliver an electrical shock to attempt to restore a normal heart rhythm.
• Ensure all staff are fully aware of the Mental Capacity Act.

• Ensure an adequate business continuity plan is in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 September 2015

The practice is rated as good for the care of people with long-term conditions. Practice staff held a register of patients who had long term conditions and carried out regular reviews. There was a recall system in place when patients failed to attend for their reviews. For patients with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 September 2015

The practice is rated as good for the care of families, children and young people. Practice staff liaised with local health visitors to offer a full health surveillance programme for children. Checks were also made to ensure maximum uptake of childhood immunisations. The practice nurse offered immunisations to children in line with the national immunisation programme. Alerts and protection plans were in place to identify and protect vulnerable children.

Updated 10 September 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, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 10 September 2015

This practice is rated as good for the care of working age patients, recently retired people and students. The practice provided extended opening hours twice a week from 6.30pm to 8.30pm for patients who were unable to visit the practice during normal working hours. The practice also had arrangements for patients to have telephone consultations with a GP. The practice was proactive in offering a full range of health promotion and screening that reflected the needs of this age group. This included health checks for patients aged 40 to 70 years of age. Many of the staff were multilingual which helped reduce language barriers. The practice also had access to interpreters and staff were aware of how to book an interpreter.

Updated 10 September 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 patients experiencing poor mental health, including those with dementia. The practice 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. Annual health checks were offered to patients with long term mental health conditions.

Updated 10 September 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 those with a learning disability. It had carried out annual health checks for patients with a learning disability and most of these patients had received a follow-up. It offered longer appointments for these patients. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. GPs carried out home visits to patients who were housebound and to other patients on the day they had been requested. Staff were aware of their responsibilities about sharing information, documenting safeguarding concerns and how to contact the necessary agencies in normal working hours and out of hours.