Saint Vincent Practice

Updated 11 November 2016

Saint Vincent practice is located on the outskirts of Doncaster town centre. It has a branch surgery at the Hollybush Health Centre in Edenthorpe on the outskirts of Doncaster.  T he practice provides services for 14,739 patients under the terms of the NHS General Medical Services contract. The practice catchment area is classed as within the group of the fourth more deprived areas in England. The age profile of the practice population is similar to other GP practices in the Doncaster Clinical Commissioning Group (CCG) area.

The practice has eight GP partners, two female and six male. They are supported by a care-coordinator and senior nurse, two advanced nurse practitioners, six practice nurses, five healthcare assistant, a practice manager and a team of reception and administrative staff.

The practice is open between 8am to 6pm Monday to Friday. Evening appointments are offered with all staff on Wednesday until 7.30pm at the Thorne Road site and from 7am on Thursday mornings. Appointments are available with all staff at the Hollybush site from 7am on Thursday mornings for working patients who could not attend during normal opening hours.

A phlebotomy service with the healthcare assistant is available daily. In addition to pre-bookable appointments that could be booked up to two weeks in advance, urgent appointments ware also available for people that need them.

When the practice is closed calls are answered by the out-of-hours service which is accessed via the surgery telephone number  or by calling the NHS 111 service.  

Updated 11 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Saint Vincent Practice on 13 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.

• 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 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 areas of outstanding practice:

• The practice had developed a clinical Care Co-ordinator role to review those admitted to hospital, who attended accident and emergency regularly or used other services frequently. The Care Co-ordinator would meet with the patient at their home or at the practice to review their health and social circumstances, with their carers present when relevant. The Care Co-ordinator was supported by a GP, a nursing assistant and an administrator. Since inception in October 2014, 281 patients had been reviewed by the Care Co-ordinator service. Feedback from patients was extremely positive.  The number of patients with a long term condition admitted to hospital as an emergency was 2% lower than the CCG average of 19%. 
• The premises had been assessed as a safe area for those whose circumstances may make them vulnerable for patients registered with the practice and from the local area. Some people used the practice address as a point of contact for written communication from hospital and social care services. Mail would be delivered to the practice and kept for the person to pick up.
• Where changes to a policy or procedure were made as a result of a complaint, the complainant was invited back into the practice to be appraised of the improvements. This provided the complainant with the opportunity to review the new policy or procedure and provide further comment whether the changes implemented would prevent the same thing happening again.
• The practice facilitated a programme of patient engagement events where practice staff and external speakers facilitated educational events for patients and people from the local community. Topics included living with dementia, social prescribing, cancer care and healthy eating. Patients told us they enjoyed the sessions and found them very informative and people came from other areas to attend.

The areas where the provider should make improvement are: 

• Review the Resuscitation Council UK Quality standards for checking cardiopulmonary resuscitation equipment and implement a weekly checking regime.

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.

• Practice nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority. The Care Co-ordinator would follow up those patients who were admitted to hospital or attended accident and emergency.
• Performance for diabetes related indicators was 3% below the CCG average and 4% above the national average.
• 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 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 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. 
• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG and 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 midwifes and health visitors. 

Updated 11 November 2016

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

• All older patients had a named GP.
• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Named GP's took the lead for the nursing and residential homes allocated to the practice. The Care Co-ordinator and the healthcare assistant held a clinic at each of the home incorporating long term condition reviews along with regular appointments. They used laptops to record the consultations directly onto the patient record. The named GP would visit as required.

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 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.

Updated 11 November 2016

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

• All patients diagnosed with dementia who 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 with poor mental health, 99% had a comprehensive care plan in place 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 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.
• Staff were trained dementia friends.
• The practice facilitated a programme of patient engagement events where practice staff and external speakers facilitated educational events for patients and people from the local community. Topics included living with dementia, social prescribing, cancer care and healthy eating. Patients told us they enjoyed the sessions and found them very informative and people came from other areas to attend.

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 people and those with a learning disability.
• The practice offered longer appointments for those who needed them.
• 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.
• The premises had been assessed as a safe place for adults with a learning disability to go to when they were out and about in Doncaster if they felt unsafe or unwell. Others  used the practice address as a point of contact for written communication from hospital and social care services. Mail would be delivered to the practice and kept for the person to pick up.
• The practice facilitated a programme of patient engagement events where practice staff and external speakers facilitated educational events for patients and people from the local community. Topics included living with dementia, social prescribing, cancer care and healthy eating. Patients told us they enjoyed the sessions and found them very informative and people came from other areas to attend.