Grovelands Medical Centre Also known as Dr D.A. Riley & Partners

Updated 11 November 2016

Grovelands Medical Centre provides GP services to around 14,000 patients in a suburban area of Reading. It is based in an area of mixed ethnicity and this is reflected in its patient list. The locality has a relatively medium level of deprivation, with a higher working age population (between 25 and 40 years) compared to the national average and average life expectancy.

The practice has eight GP partners, six female and two male, and three GP associates (two male and one female). It currently has five practice nurses and two health care assistants. There are 17 members of patient services team, and a practice manager and deputy practice manager.

Grovelands Medical Centre comprises two floors. The ground floor has ten GP consulting rooms and two nurse treatment rooms. There is a large reception area where all administration and reception staff work together. The second floor is for the management team. There is step free access to the main entrance, and automatic entrance doors.

The practice is open from 8am to 6.30pm Monday to Friday. Extended hours are available on Saturday mornings for pre-booked appointments.

Grovelands Medical Centre operates with a Personal Medical Services contract. They offer enhanced services for childhood immunisations, improving patient online access, influenza and pneumococcal immunisations and avoiding unplanned admissions.

The practice has opted out of providing out of hours services to their patients. The out of hours service is provided by West Berkshire out of hours service (Westcall) and is accessed by calling NHS 111. Advice on how to access the out of hours service is contained on a recorded message when the practice is closed.

Grovelands Medical Centre is registered to provide services from the following location:

701 Oxford Road, Reading, Berkshire, RG30 1HG

This is the first inspection of Grovelands Medical Centre

Updated 11 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grovelands medical centre on 8 September 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.
• All staff had received safeguarding relevant to their role and had also attended extra domestic abuse training due to the high levels of abuse cases within the local community.
• 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 innovative and proactive methods to improve patient outcomes. For example, reception staff were given extra training in talking to young patients about contraception in a discreet manner.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.

The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 November 2016

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

• The lead GP and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was 93% which was higher than the clinical commissioning group (CCG) average of 80% and national average of 89%.

• Longer appointments and home visits were available when needed

• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the lead GP worked with relevant health and care professionals to deliver a multidisciplinary package of care

• The practice participates in the clinical commissioning group complex case management scheme which provides proactive care for those at highest risk of emergency admission.

• Long term condition review clinics were held by the practice nurses. The nurses are trained in management of chronic obstructive pulmonary disease, cardiovascular disease, asthma and diabetes (including insulin initiation).

• Performance for chronic obstructive pulmonary disease (COPD, a collection of lung diseases including chronic bronchitis and emphysema) indicators showed the practice had achieved 100% of targets which was similar when compared to the CCG average (96%) and higher when compared to the national average (96%).

Updated 11 November 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.

• The practice were fully involved with safeguarding procedures. They held regular meetings with health visitors and had provided training in female genital mutilation and domestic abuse in response to their population.

• Childhood immunisation rates for the vaccinations given was comparable to the CCG average. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from % (CCG average 81% to 93%) and five year olds from (CCG average 81% to 92%).

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• The practice’s uptake for the cervical screening programme was %, which was comparable to the CCG average of 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 and school nurses.

• The practice provides a range of in-house contraceptive services. Reception staff were given further training in communication with younger patients who may require access to contraception advice. This enabled them to offer an appropriate appointment in a discreet manner.

Updated 11 November 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 practice worked with multi-disciplinary teams in the care of older vulnerable patients.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were in line with local and national averages. For example, the number of emergency admissions per 1,000 population was 14, compared to the CCG average of 12 and the national average of 14.

• 100% of patients aged 50 or over (and who have not attained the age of 75) with a fragility fracture and confirmed diagnosis of osteoporosis, were currently treated with an appropriate bone-sparing agent. This was higher when compared to the local clinical commissioning group average (61%) and national average (81%).

• Immunisation campaigns for the elderly such as flu, shingles and pneumonia were advertised through posters, messages on prescriptions, website updates and letters, with follow up phone calls to those who have not attended.
• The practice works closely with community matrons and care co-ordinators to promote better health.

Updated 11 November 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 surgery offered extended pre-bookable appointments on a Saturday.

• 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 uses IT to improve access for patients. Including online appointment booking, automated 24 hour telephone booking and cancellation of appointments. Text reminders are used to encourage attendance at appointments and to remind patients of series such as flu clinics.

• The practice’s uptake for the cervical screening programme was 81%, which was higher than the CCG average of 78% and the national average of 82%.

Updated 11 November 2016

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

• 86% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the local average of 84% and the national average of 84%.

• 92% of patients with a severe mental health issue who had a comprehensive, agreed care plan documented in the last 12 months, which was comparable to the local average of 90% 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.

• Proactive dementia screening was undertaken for at risk patients.

• 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.

• The administration team regularly recall patients for mental health checks and offer reminder calls on the day of appointment for those with dementia.

Updated 11 November 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 patients, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice had completed 71% of learning disability health checks, which is above the national average of 44%.

• The practice offers weekly visits to a learning disabilities residential unit for those unable to attend the surgery.

• The practice had told vulnerable patients about how to access various support groups and voluntary organisations.

• GPs worked within a multi-disciplinary team to ensure the best outcomes for vulnerable patients.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• GPs were trained in drug addiction to enable them to support patients in-house. Weekly contact with drug and alcohol services is maintained to ensure prescribing is appropriate and meets the patient’s needs.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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.