Parkside Medical Practice

Updated 31 August 2016

Parkside Medical Practice provides primary medical services to approximately 6780 patients through a general medical services contract (GMS).

The practice is located in purpose built premises close to Nottingham city centre. The practice occupies an area of the first floor of a community building which also provides local residents with access to council services including housing and library services. There is a café on the ground floor and the practice is accessible by a lift. Various community health services are also provided form this location in addition to another GP practice. The complex has car parking, parking for the disabled and is accessible by public transport.

The level of deprivation within the practice population is significantly above the national average with the practice population falling into the most deprived decile. Income deprivation affecting children and older people is above the national average.

The clinical team comprises four GP partners (two male, two female), one GP associate (male) one nurse practitioner, two practice nurses and one healthcare assistant. The clinical team is supported by a full time practice manager and a team of reception and administrative staff.

The practice opens from 8am to 7.30pm Monday to Friday with the exception of Thursday when practice closes at 12.30pm. Consulting times vary but are generally from 9am to 12pm each morning and from 2.30pm to 6.30pm each afternoon. Extended hours appointments are offered four days per week from 6.30pm to 7.30pm.

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 31 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkside Medical Practice on 1 June 2016. Overall the practice is rated as good.

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

• The practice demonstrated an open and transparent approach to safety. There were robust systems in place to enable staff to report and record significant events. Learning from significant events was shared widely.
• Risks to patients were assessed and well managed. There were arrangements in place to review risks on an ongoing basis to ensure patients and staff were kept safe.
• Staff delivered care and treatment in line with evidence based guidance and local guidelines. Training had been provided for staff to ensure they had the skills and knowledge required to deliver effective care and treatment for patients.
• There was a demonstrated understanding of performance within the practice. Systems were in place to support staff in undertaking regular clinical audits. Clinical audits were relevant and showed improvements in the quality of care provided to patients.
• Feedback from patients was that they were treated with kindness, dignity and respect and were involved in decisions about their care.
• 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.
• The practice proactively sought feedback from patients through the use of survey which could be completed via mobile phone. Feedback was used to make improvements in the delivery of service.
• Patients said they could generally get an urgent appointment when they needed one but that it could be difficult to get through the practice by telephone. Patients also said that it was difficult to book appointments in advance.
• There were systems in place to monitor demand for appointments and the practice continually sought to improve access for patients.
• The practice had good facilities and was well equipped to treat patients and meet their needs. The premises were suitable for patients with a disability.
• There was a clear leadership structure which all staff were aware of. Staff told us they felt supported by the partners and management.
• The practice had developed effective working relationships with their patient participation group (PPG) and acted on their suggestions for improvement.
• There was a clear mission statement which had been co-authored by staff and patients. The mission statement was supported by clear business plans which were regularly reviewed and monitored.
• All staff had been involved in setting 12 month and five year goals for the practice which were used to develop objectives.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The leadership team within the practice had worked with their staff and patients (through the patient participation group) to co-author their mission statement. This contributed to a high level of engagement from staff and patients to a shared set of values which underpinned the work being done by the practice.

There were areas where the provider should make improvements:

• The provider should continue to review their appointments system to improve access to routine/pre-bookable appointments.
• Ensure all required pre-employment checks are undertaken prior to new members of staff starting or undertake a documented assessment of the risk of not doing so.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 August 2016

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

• Clinical staff had lead roles in managing patients with long-term conditions and those patients identified as being at risk of admission to hospital were identified as a priority.
• Performance for diabetes related indicators was 81.9% which was 2.8% above the CCG average and 7.3% below the national average. The exception reporting rate for diabetes indicators was 10.2% which was in line with the CCG average of 9.8% and the national average of 10.8%.
• Longer appointments and home visits were available when needed to facilitate access for these patients.
• All these patients had a named GP and were offered regular reviews to check their health and medicines needs were being met. Annual reviewed were undertaken in the month of the patient’s birthday and patients were followed up if they did not respond.
• For patients with the most complex needs, the named GP worked with relevant health and social care professionals to deliver a multidisciplinary package of care. In addition to multidisciplinary meetings held on a monthly basis, the practice held weekly clinical meetings where vulnerable patients were discussed.
• Patients with asthma received personalised care plans.

Updated 31 August 2016

The practice is rated as good for the care of families, children and young people.

• Systems were in place to identify children at risk. The practice had a dedicated child safeguarding lead and staff were aware of who this was. We saw positive examples of joint working with midwives, health visitors and school nurses.
• Extended hours appointments were regularly offered from 6.30pm to 7.30pm to ensure appointments were available outside of school hours.
• Vaccination rates for childhood immunisations were generally in line local averages.
• The premises were suitable for families, children and young people. The practice was situated in a development which housed other local services including the library, a café and council housing services.
• Young people’s health clinics were offered by the practice.
• The practice had recently appointed a member of staff as a champion for young people to aim to represent their views and interests at meetings.

Updated 31 August 2016

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

• Personalised care was offered by the practice to meet the needs of its older population. The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Longer appointments were also provided for older people on request.
• The nursing team maintained a register of people who were housebound to facilitate long-term condition reviews at home.
• A phlebotomy service was provided by the practice for people who were housebound in conjunction with a neighbouring practice.
• Services were provided to a number of older people in nursing homes. Ward rounds were undertaken twice per month and patients reviewed twice a year.
• The practice had recently identified an older persons’ champion to represent the interests of this group at practice meetings.

Updated 31 August 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 offered services which were accessible and flexible. For example extended hours appointments were offered most days from 6.30pm to 7.30pm to facilitate access for working patients.
• The practice was proactive in offering online services including appointment booking and online prescription services.
• A range of health promotion and screening services were offered and promoted that reflected the needs of this age group. Uptake rates for cervical cancer screening, bowel cancer screening and breast cancer screening were in line with local and national averages.
• A range of services were offered at the practice to facilitate patient access including minor surgery and joint injections.
• Text messaging was used to confirm appointments and recall patients for blood test results. The practice also used text messaging to request feedback about services.

Updated 31 August 2016

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

• Performance for mental health related indicators was 83.2% which was 5.5% below the CCG average and 9.6% below the national average. The exception reporting rate for mental health related indicators was 4.6% which was below the CCG average of 10.5% and above the national average of 11.1%.
• 76.9% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was 7% below the CCG average and 7.1% below the national average. This exception reporting rate for this indicator was 4.4% which was below the CCG average of 8.5% and the national average of 8.3%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice 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 31 August 2016

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

• The practice maintained a register of patients who were housebound.
• Information was available which informed vulnerable patients about how to access local and national support groups and voluntary organisations.
• Translation services were provided where these were required and information was available in a range of languages.
• In order to effectively support vulnerable patients, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care. In addition to multidisciplinary meetings held on a monthly basis, the practice held clinical meetings on a weekly basis to ensure they maintained oversight of vulnerable patients.
• 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. Safeguarding concerns were regularly discussed at the weekly multidisciplinary meetings.
• The practice had undergone domestic violence training and information related to this was available in the waiting area.
• The practice had a dedicated carers champion who worked to increase the number of carers identified by the practice and signpost them to relevant services.