Trent Vale Medical Practice

Updated 16 November 2016

Trent Vale Medical Practice is registered with the CQC as a partnership provider.

The practice provides services via purpose built premises and at the time of our inspection 9,161 patients were registered to receive care and treatment. The partnership arrangements comprise of four partners holding a General Medical Services contract with NHS England.

The practice demographic is broadly similar to the national average although the practice has a 3% higher proportion of patients aged less than 18 years of age, when compared with the national average. The locality is one of less deprivation than the clinical commissioning group (CCG) area, although deprivation is higher than the national average. Geographically, the practice is less than one mile away from a major hospital serving the area.

The practice is open each weekday from 8am to 6pm. During these times the reception desk is staffed and remains open. The practice is contactable by telephone within core opening times with the exception of 1pm to 2pm and also a Thursday afternoon 1pm – 6pm. During lunchtimes an answer machine gives an emergency contact number to call and this is covered by a duty GP.

After 1pm on Thursday incoming telephone calls are diverted to the locality out-of-hours provider. Extended hours appointments with both GPs and nurses are offered on Monday and Thursday until 7:45pm. The practice has opted out of providing cover to patients outside of normal working hours. These out-of-hours services are provided by Staffordshire Doctors Urgent Care Limited.

Staffing at the practice includes:

• Seven GPs (four female, three male).

• One registrar GP (currently female)

• Two practice nurses (female)

• Two healthcare assistants (female).

• A practice manager and senior receptionist lead a team of data quality facilitators, administrative and reception staff.

Updated 16 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Trent Vale Medical Practice on 4 May 2016. A breach of legal requirement was found and a requirement notice was issued. After the comprehensive inspection the practice sent us an action plan to say what they would do to meet

legal requirements in relation to:

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Safe Care and Treatment

We undertook a focused inspection on 31 October 2016. We did not visit the practice but reviewed information sent to us by the provider. The inspection was to check that the practice had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Trent Vale Medical Practice on our website at www.cqc.org.uk.

Our key findings were as follows:

• The practice operated a safe, effective system for acting upon medicine safety alerts.

• The process for investigating and recording significant events was comprehensive, thorough and used regularly.

• The practice had an automated external defibrillator (AED) available if required in a serious medical emergency.

Overall the practice is rated as good overall and good in the safe domain. The change of rating in the safe domain means that the care the practice provides to patients whose circumstances make them vulnerable is now rated as outstanding. This recognises the improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 June 2016

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

• Patients at the highest risk to unplanned hospital admissions were identified and care plans had been implemented to meet their health and care needs.

• Longer appointments and home visits were available when needed.

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

• Nursing staff had lead roles in chronic disease management and had undertaken additional training.

Updated 17 June 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. Immunisation rates were relatively high for all standard childhood immunisations.
• 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 78% compared with the CCG average of 80% and national average of 82%.

Updated 17 June 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.

• We saw examples where the practice had proactively and quickly responded to concerns about the wellbeing of patients in this group.

Updated 17 June 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice offered appointments outside of core working hours and provided online services to enable patients to book appointments, order repeat medicines and access some parts of their health records online.
• Health promotion and screening services reflected the health needs of this group.

Updated 17 June 2016

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

• Performance for poor mental indicators was better than local and national averages. For example, 95% of patients with enduring poor mental health had a recent comprehensive care plan in place compared with the CCG average of 86% and national average of 88%.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had an effective system in place to ensure that patients who had attended with symptoms with depression were followed up appropriately over time.
• 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 17 June 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 known vulnerable adults, those who were housebound and patients with a learning disability.

• The practice had 50 patients recorded with a learning disability. All of these patients had received an annual health assessment. This performance was significantly higher than the national average uptake of around 50%.

• Staff adapted their processes to suit the needs of patients. For example, staff sent easy read letters of invitation to patients when this would help their understanding. They also planned more time when booking appointments.

• Staff had a good awareness of vulnerable patients in their care; they prioritised actions and regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.