Doctors Coskery, Maher & Oliver

Updated 25 April 2016

Doctors Crawley, Field, Coskery, Noble and Maher, also known as Wincobank Medical Centre is located in a purpose built health centre in Wincobank and accepts patients from the surrounding area. The practice catchment area has been identified as one of the third most deprived areas nationally.

The practice provides Primary Medical Services (PMS) under a contract with NHS England for 7250 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as minor surgery, anticoagulation monitoring and childhood vaccination and immunisations.

The practice has five GP partners (four female, one male), one female nurse practitioner, three female practice nurses, two female healthcare assistants, practice manager and an experienced team of reception and administration staff. The practice is a teaching and training practice for medical students and trainee GPs.

The practice is open 8am to 6.30pm Monday to Friday and offers morning and afternoon appointments daily. Extended hours are offered Monday and Friday mornings 7.30am to 8am and Saturday mornings 8am to 11am. When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. Patients are informed of this when they telephone the practice number.

The practice is registered to provide the following regulated activities; treatment of disease, disorder or injury, diagnostic and screening procedures, maternity and midwifery services, surgical procedures and family planning.

Updated 25 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Doctors Crawley, Field, Coskery, Noble & Maher (known as Wincobank Medical Centre) on 17 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 it easy to make an appointment 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 registered provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• We were told how the GPs had been trained to use specialist equipment to perform a procedure, normally carried out by a practice nurse for a patient who worked away all week so they could offer the patient the regular monitoring treatment they required on a Saturday at the extended hours clinic (when there was no nurse on duty).

The areas where the provider should make improvement are:

The practice should ensure all records relating to staff management are fully completed and signed, for example, recruitment and staff appraisal documentation.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 25 April 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.

• 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 25 April 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. Childhood immunisation rates were comparable to national averages.

• 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.

• Data showed 83% of women eligible for a cervical screening test had received one in the previous five years compared to the national average of 81%.

• All children were offered a same day appointment. 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 and health visitors.

Updated 25 April 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.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was 81%, higher than the national average of 73%.

Updated 25 April 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 offered early morning appointments at the practice on Monday and Friday mornings and appointments at the practice on a Saturday morning. The practice also offered weekend and evening appointments through the Sheffield satellite clinical scheme.

• 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.

• The practice offered same day appointments at the urgent clinic and GP telephone advice for those who could not attend the practice.

• We were told how the GPs had been trained to use specialist equipment to perform a procedure, normally carried out by a practice nurse for a patient who worked away all week so they could offer the patient the treatment on a Saturday at the extended hours clinic (when there was no nurse on duty).

Updated 25 April 2016

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

• Of those patients diagnosed with dementia, 95% had received a face to face care review meeting in the last 12 months, which was higher than the national average of 84%.

• Of those patients diagnosed with a mental health condition, 73% had a comprehensive care plan reviewed in the last 12 months, which is below 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT) to support patients’ needs.

Updated 25 April 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 and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multidisciplinary teams in the case management of vulnerable people. The practice hosted a community support worker who would advise and signpost patients to services. For example, information on housing and social care or support to join local social activities.
• The practice provided medical care and twice weekly routine GP visits to patients who resided in a local care home for patients with complex health needs.
• 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.