Gnosall Surgery

Updated 7 February 2017

Gnosall Surgery is registered with CQC as a partnership provider operating out of a new purpose built premises in Gnosall. Car parking, (including disabled parking) is available at this practice.

The practice holds a Personal Medical Services contract with NHS England.

The practice is part of the NHS Staffordshire and Surrounds Clinical Commissioning Group.

The practice area is one of less deprivation when compared with the local average and national average. The practice has a higher than average rate of male and female patients aged 40 and over compared with the national averages. The rate of patients aged 75 and over are as per the local and national average.

At the time of our inspection the practice had 8106 registered patients.

The practice staffing comprises of:

• Four GP partners

• One physician associate

• Three practice nurses

• One healthcare assistants/phlebotomist

• One eldercare facilitator

• The practice manager who oversees the operational delivery of services supported by a team of administrative staff.

The practice is open between 8am and 6.30pm Monday to Friday. Extended hours appointments are offered between 6.30pm and 7.30pm on Mondays and Thursdays. The practice is closed one afternoon each month for team training (details are available on the practice website).

When the practice is closed patients are advised to call the surgery where their call will be diverted after 6.30pm to the designated out of hours service, which is provided by Staffordshire Doctors Urgent Care service.

Updated 7 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gnosall Surgery on 10 October 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.
• Most risks to patients were assessed and well managed.
• 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.
• 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.

We saw one area of outstanding practice:

The practice had a well-established and award winning memory service, which was led by a psychiatrist and supported by an eldercare facilitator. All patients with a memory concern, who wished to have further assessments, were referred to the clinic for assessments, diagnosis and support.

There were areas of practice where the provider needs to make improvements.

The provider should:

• Keep the protocol to follow-up on medical alerts such as the Medicines and Healthcare products Regulatory Agency (MHRA) under review to ensure it is effective in identifying patients at risk. This includes documenting the action taken in response to the alerts.

• Implement a consistent system for checking and evidencing that monitoring for patients who take long term medicines on a shared care basis, has been provided before the prescriptions are re issued.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 February 2017

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.

• The percentage of patients with diabetes, on the register, who had influenza immunisation was 97%, this was the same as the CCG average and higher than the national average of 95%.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading in the last 12 months was 140/80 mmHg or less was 83%. This was higher than the CCG average of 72% and the national average of 78%.

• 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 7 February 2017

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.

• Appointments were available outside of school hours. Children aged16 and under with acute illnesses were offered same day access.

• The premises were suitable for children and babies. Breast feeding and baby changing facilities were provided on request.

• We saw positive examples of joint working with midwives and health visitors. Midwives offered a weekly in-house antenatal clinic and regular baby clinics and post-natal groups were held by Health Visitors and supported by GPs.

• Meningitis A,C,W, and Y vaccination was offered to university students.

• The practice offered a nurse led family planning service.

• The practice had a young people information section in the waiting area and on their website, with a young persons frequently asked questions (FAQ) leaflet available.

Updated 7 February 2017

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 offered dedicated appointment slots with each doctor for patients aged 75 and over.

• Elderly patients who were house-bound with multiple long term conditions were offered an annual home visit.

• Patients were invited to attend the surgery for vaccines to prevent illnesses such as the flu and shingles.

Updated 7 February 2017

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. 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 reflected the needs for this age group.

• Patients had direct access to physiotherapy triage, assessment and treatment within the practice.

• The practice offered early appointments from 08.00am and offered extended hours until 7.30pm on Mondays and Thursdays to try and accommodate working age people who would otherwise struggle to get to an appointment during their working day.

Updated 7 February 2017

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

• 73% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average.

• The practice offered an in house memory service with a psychiatrist and care facilitator. The clinic was set up for patients with memory concerns who wished to have further assessments. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice carried out advance care planning for patients with dementia.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those patients with dementia.

• Staff had a good understanding of how to support patients with mental health needs and dementia. All the staff were trained with Dementia awareness and were ‘Dementia Friends’. The practice manager was a ‘Dementia Champion’.

Updated 7 February 2017

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 seasonal workers and canal boat residents and people with a learning disability.

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

• The practice 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.

• 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.