Family Medical Centre - Sood

Updated 12 May 2016

Family Medical Centre provides primary medical services to approximately 8679 patients through a general medical services contract (GMS). The practice is located in purpose built premises near to Nottingham city centre. The premises were extended in 1986 and 2010 to enable the practice to expand the services offered. The practice has car parking facilities and is accessible by public transport.

The level of deprivation within the practice population is above the national average. The practice is in the second most deprived decile meaning that it has a higher proportion of people living there who are classed as deprived than most areas.

The clinical team comprises six GPs partners (four male and two female), three practice nurses and two phlebotomists. The clinical team is supported by a full time practice manager, an office manager/assistant practice manager and a team of reception and administrative staff.

The practice opens from 8am to 6.30pm Monday to Friday. Consulting times are from 8am to 12.30pm and from 2pm to 6pm with a duty doctor available until 6.30pm. Extended hours are offered on a Saturday morning from 8.30am to 12.45pm for routine appointments.

The practice is an approved teaching and training practice for medical students, nursing students and GP registrars. (A GP registrar is a qualified doctor who is training to become a GP through a period of working and training in a practice)

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by NEMS and is accessed via 111.

Updated 12 May 2016

Letter from the Chief Inspector of General Practice

carried out an announced comprehensive inspection at Family Medical Centre on 1 March 2016. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Learning was shared widely across all staffing groups.
• 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.
• The practice used clinical audit to drive quality improvement within the practice
• Feedback from patients about their care and treatment was positive.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. For example the practice had close working relationships with homeless services within the city and provided outreach clinics on a weekly basis.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, the practice had worked with a local young people’s group to review their services and had developed an action plan as a result of their recommendations.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result. All staff were involved in reviewing complaints to identify learning.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• The practice was proactive in working with other local providers. For example, the practice had recently been awarded research hub status and was being supported by a number a local practice to lead on research.

We saw several areas of outstanding practice including:

• The practice was committed to working with people whose circumstances might make them vulnerable. For example; the practice had a long history of working with homeless patients across Nottingham. In addition to removing barriers for these patients to access services at the practice, they undertook outreach clinics in local hostels on a weekly basis. Weekly substance misuse clinics were run from the practice.
• Staff had received training in domestic violence awareness and had dedicated domestic violence champions. The practice worked closely with local services providing support to people who had suffered domestic violence.
• There was a high level of engagement with younger people. For example, the practice had dedicated leaflets for younger people explaining the service they provided at the practice and detailing other services which were available in the local area including sexual health services. In order to ensure they were accessible to younger people the practice had worked with a local young people’s organisation, Future Pulse, to review their services. The practice had received positive feedback following the review and had developed an action plan in response to the recommendations for improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 May 2016

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

• Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Monthly multidisciplinary meetings were held at the practice to discuss patients at risk of admission to hospital.
• The practice had identified diabetes as an area for improvement. For example,
• Joint clinics were undertaken with a diabetic specialist nurse on a regular basis to facilitate the management of complex patients. This also served to enhance the skills of the practice based nurses.
• 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.
• A dedicated member of administrative staff monitored patients who did not attend for scheduled appointments.

Updated 12 May 2016

The practice is rated as outstanding 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. The practice had a dedicated safeguarding lead who held monthly meetings with the health visitor, midwife and the practice’s nursing safeguarding lead.
• The practice demonstrated that they were very proactive in trying to continually improve immunisation rates. Parents of children requiring immunisations were frequently contacted in excess of five times by telephone and in writing. The practice also liaised with community staff proactively to increase uptake rates. Weekly drop-in vaccination clinics were offered to help increase uptake rates.
• 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered weekly integrated drop-in baby clinics where parents could bring children to see the practice nurse, health visitor or a GP.
• The practice demonstrated it was responsive to young people through their work with local young people’s organisation, Future Pulse, who undertook a review of their service. The practice was acting on recommendations made by Future Pulse.
• Weekly drop in family planning clinics were provided which offered sexual health screening and participated in the c-card scheme (which enabled access to free contraception for people aged 13 to 24).

Updated 12 May 2016

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.
• Routine chronic disease reviews were undertaken at home for housebound patients.
• The practice had dedicated GPs for local nursing homes who undertook regular ward rounds to provide continuity of care for the patients.
• Older patients at risk of admission to hospital were discussed at monthly multidisciplinary meetings hosted by the practice.

Updated 12 May 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.
• Telephone consultations were offered in addition to extended hours services on a Saturday morning.
• 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 12 May 2016

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

• 91% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months which was above the CCG average of 83.9% and the national average of 84%.
• 85% of patients with a mental health condition had a documented care plan in the last 12 months which was in line with the CCG average of 83.6% 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 carried out advance care planning for patients 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 12 May 2016

The practice is rated as outstanding for the care of people who circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.
• The practice had a lead GP for patients with a learning disability and offered longer appointments for these patients.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients. For example the practice provided weekly substance misuse clinics in conjunction with the substance misuse worker for 15 to 20 people.
• Twice weekly outreach sessions were provided at local homeless hostels and more than of 300 consultations had been carried out with homeless patients in the last year.
• 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. Additionally staff were trained in the identification of patients who may have been subject to domestic violence.