Great North Medical Group

Updated 5 May 2016

Carcroft Doctors Group is located in Carcroft on the outskirts of Doncaster. The practice provides services for 10,695 patients under the terms of the NHS General Medical Services contract. The practice catchment area for both practices is classed as within the group of the third more deprived areas in England. The age profile of the practice population is similar to other GP practices in the Doncaster Clinical Commissioning Group (CCG) area.

The practice has four  GP partners, two female and two male, and a male salaried  GP.  They are supported by an advanced nurse practitioner,  four practice nurses, two healthcare assistants, a a practice manager, an assistant practice manager, an office manager and a team of administration staff.

The practice is open between 8am and 6pm Monday to Friday. E arly morning appointments with the GP and practice nurse are available on Tuesday and Wednesday mornings from 7am and until 7pm on Tuesday evenings. A walk in phlebotomy clinic is held every weekday morning with the healthcare assistant. Appointments with staff were available at various times throughout the day.  Patients requesting same day appointments are triaged over the telephone by a GP or advanced nurse practitioner and offered a face to face appointment with GP or practice nurse if required.

When the practice is closed calls were answered by the out-of-hours service which is accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 5 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Carcroft Doctors Group on 8 March 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 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.
• Patients said they found the telephone access to the practice difficult first thing in the morning as the lines were often engaged.  Once calls were answered 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.

We saw two areas of outstanding practice:

• We received several comments from patients experiencing poor mental health who complimented the service and support offered to them at the practice. They described how, in times of crisis, the staff were supportive and responsive to their needs. For example, by offering appointments with a GP before the practice opened when there were less people around.
• The lead GP at the practice held a community gynaecology clinic serving the female population of north west Doncaster locality. This negated the need for patients registered at the practice and other practices in Doncaster to travel to the hospital for some gynaecological procedures. A practice nurse was a trained colposcopy nurse. Patient’s feedback on the CQC comment cards said this was ‘a fabulous service close to home’.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 5 May 2016

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

• Nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.  
• Patients who had multiple long term conditions received a complete and thorough review in one longer appointment. This negated the need for multiple appointments.
• Performance for diabetes related indicators was 94% which was 1.8% below the CCG average and 5% above the national average.
• 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 5 May 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 accident and emergency attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• 74% of patients diagnosed with asthma, on the register, who had an asthma review in the the last 12 months.
• 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.
• The practice’s uptake for the cervical screening programme was 80%, which was just below the CCG average and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors, school nurses and school teachers.
• The lead GP at the practice held a community gynaecology clinic serving the female population of north west Doncaster locality. This negated the need for patients registered at the practice and other practices in Doncaster to travel to the hospital for some gynaecological procedures. A practice nurse was a trained colposcopy nurse. Patient’s feedback on the CQC comment cards said this was ‘a fabulous service close to home’.

Updated 5 May 2016

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

• All patients had a named GP.
• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Each GP took the lead for one of the five nursing or residential homes allocated to the practice. They each held a weekly clinic at the home incorporating medication and long term condition reviews along with regular appointments. They used laptops to record the consultations directly onto the patient record.

Updated 5 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.
• 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 5 May 2016

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

• 92% of patients diagnosed as living with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.
• 96% of patients experiencing poor mental health had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 88%.
• The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those living 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 had been trained as dementia friends.
• We received several comments from patients' experiencing poor mental health who complimented the service and support offered to them by the practice. They described in times of crisis the staff were supportive and responsive to their needs. For example by offering appointments with a GP before the practice opened when there were less people around.  These patients were offered weekly prescriptions to help them manage their medicines.

Updated 5 May 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 homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for those who needed them.
• The practice regularly worked with multidisciplinary teams in the case management of those whose circumstances may make them vulnerable.
• The practice informed patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in 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.