Norwood Medical Centre

Updated 27 June 2016

Norwood Medical Centre is located in Norwood, Sheffield and accepts patients from Norwood, Southey, Longley and the surrounding area. The practice catchment area has been identified as one of the first most deprived areas nationally.

The practice provides General Medical Services (GMS) under a contract with NHS England for 7,883 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.

Norwood Medical Centre has five GP partners (four female, one male), one female salaried GP, one nurse practitioner, three practice nurses, one healthcare assistant, practice manager and an experienced team of reception and administration staff. The practice is a training practice for medical registrars.

The practice is open 8.45am to 6pm Monday to Friday with the exception of Thursdays when the telephones are transferred to the GP collaborative at 12 noon who provide cover on a Thursday afternoon. Extended hours are offered Monday mornings with two GPs and Wednesday evenings with one GP. Morning and afternoon appointments are offered daily Monday to Friday with the exception of Thursday afternoon when there are no routine afternoon appointments.The practice is currently offering pre-booked GP appointments with one GP on a Thursday afternoon as part of a local pilot scheme.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. The Sheffield GP Collaborative provides cover when the practice is closed between 8am and 6.30pm. For example, between 8am and 8.45am. 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 and diagnostic and screening procedures.

As part of the Care Quality Commission (Registration) Regulations 2009: Regulation 15, we noted the regulated activities the practice were undertaking did not reflect the registration. We saw evidence application forms had been submitted to provide the regulated activities not registered.

Updated 27 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Norwood Medical Centre on 17 May 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 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 could 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 developed a Stroke Club to address social isolation, offer support and provide patient education for patients who had experienced a stroke and their carers. The group met at the practice regularly and the practice nurse would attend to offer support and guidance. It was well attended and the practice put on activities such as chair aerobics and fire safety talks for the group.

The areas where the provider should make improvement are:

• The practice should ensure the soap dispensers in the treatment rooms and toilets are wall mounted as identified on the infection control audit action plan.
• The practice should record the cleaning of equipment used for patient care.
• The practice should ensure all staff who chaperone patients have a Disclosure and Barring (DBS) check completed. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 June 2016

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

• Practice nursing staff had lead roles in long term condition 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. For example, the Diabetic Specialist Nurses.
• The practice had employed a community practice nurse to provide home visits for patients with complex health needs to offer an holistic approach to their care and management of long term conditions.
• The practice had developed a Stroke Club to address social isolation, offer support and provide patient education for patients who had experienced a stroke and their carers. The group met at the practice regularly and the practice nurse would attend to offer support and guidance. It was well attended and the practice put on activities such as chair aerobics and fire safety talks for the group.
• The practice had a library of books and videos to enable patients to access information on health including long term conditions such as diabetes.

Updated 27 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 accident and emergency 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.
• 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 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 and health visitors.

Updated 27 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.
• The percentage of patients aged 65 or over who received a seasonal flu vaccination was 78%, higher than the national average of 73%.
• The practice provided medical care and weekly routine GP visits to patients who resided in two local care home.

Updated 27 June 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 on a Monday with two GPs and on a Wednesday evening with one GP. The practice also offered weekend and evening appointments at a local practice 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.

Updated 27 June 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, 86% had had their care reviewed in a face to face meeting in the last 12 months, which is above  the national average of 84%.

• Of those patients diagnosed with a mental health condition, 90% had a comprehensive care plan reviewed in the last 12 months, which is above  the national average of 88%.

• The practice regularly worked with multidisciplinary teams in the case management of patients 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.

• 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 practice hosted Improving Access to Psychological Therapies Programme (IAPT), a counselling service to support patients’ needs.

Updated 27 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 those 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.