The Charnwood Practice

Updated 9 August 2016

The Charnwood Practice is a GP practice providing primary medical services to around 6,900 patients within a residential area. The practice serves a diverse patient population. The practice’s services are commissioned by Leicester City Clinical Commissioning Group (LCCCG).

The service is provided by a senior GP partner and three salaried GPs (two female GPs and two male GPs). There is a nursing team comprising of a part-time nurse practitioner, a paramedic practitioner, two practice nurses (one part-time) and a healthcare assistant. They are supported

by a business manager, practice manager and a team of reception and administration staff.

The practice is located within a purpose built health and social care centre and is situated on the ground floor.

The practice is open between 8am and 6.30pm Monday to Friday. Extended surgery hours are offered on a Wednesday between 6.30pm and 8pm. Patients can access out of hours support from the national advice service NHS 111. The practice also provides details for the nearest walk-in centre to treat minor illnesses and injuries, as well as accident and emergency departments.

Updated 9 August 2016

Letter from the Chief Inspector of General Practice

We carried out an unannounced focused inspection on 28 June 2016 to follow up concerns we found at The Charnwood Practice on 10 February 2016. Overall the practice is rated as good.

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

• The significant event policy had been reviewed to ensure the process to identify and investigate incidents and significants events was robust.

• A safety alert log recorded all safety and medicine alerts and whether it was applicable to the practice.

• The practice had devised a list of minimum content for a doctors’ bag and ensured processes were in place to review the contents of a bag and equipment was calibrated.

• A defibrillator had been purchased by the practice following completion of a risk assessment.

• A risk assessment had been completed to review the appropriate emergency medicines required to stock on the premises.

• The practice had developed the training matrix to add the appraisal and revalidation dates for GPs and nurses.

• An audit plan had been developed to ensure the findings from clinical audits were reviewed and re-audited.

• The practice had signed up for NICE guidelines for primary care to be sent directly to all GPs and nurses and ensured they were discussed at the clinical meetings.

• The governance process had been strengthened to ensure all risks had been identified, reviewed and actions taken to mitigate risk.

• The complaints process had been strengthened to ensure themes and trends could be identified, including informal complaints.

  We carried out an unannounced focused inspection on 28 June 2016 to follow up concerns we found at The Charnwood Practice on 10 February 2016. Overall the practice is rated as good.

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

• The significant event policy had been reviewed to ensure the process to identify and investigate incidents and significants events was robust.

• A safety alert log recorded all safety and medicine alerts and whether it was applicable to the practice.

• The practice had devised a list of minimum content for a doctors’ bag and ensured processes were in place to review the contents of a bag and equipment was calibrated.

• A defibrillator had been purchased by the practice following completion of a risk assessment.

• A risk assessment had been completed to review the appropriate emergency medicines required to stock on the premises.

• The practice had developed the training matrix to add the appraisal and revalidation dates for GPs and nurses.

• An audit plan had been developed to ensure the findings from clinical audits were reviewed and re-audited.

• The practice had signed up for NICE guidelines for primary care to be sent directly to all GPs and nurses and ensured they were discussed at the clinical meetings.

• The governance process had been strengthened to ensure all risks had been identified, reviewed and actions taken to mitigate risk.

• The complaints process had been strengthened to ensure themes and trends could be identified, including informal complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 August 2016

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 practice offered an enhanced diabetes service.

• Longer appointments and home visits were available when needed.

• All patients identified with a long-term condition had a named GP and a structured annual review to check their health and medicines needs were being met. Personalised care plans were in place to ensure the patients’ health and care needs were met.

• A phlebotomy service was provided with early appointments for patients that were required to fast before their blood test.

• 76% of patients diagnosed with asthma, on the practice register, had an asthma review in the last 12 months. This was comparable to the national average of 75%.

Updated 9 August 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 who were at risk, for example, children and young people who had a high number of A&E attendances.

• 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.

• The practice offered a sexual health and contraception clinic to registered and non-registered patients.

Updated 9 August 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 patients with enhanced needs.

• All patients over the age of 75 had a named GP.

• Those at high risk of hospital admission were identified and reviewed regularly, this included working with other health professionals to provide co-ordinated care.

Updated 9 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. The practice offered extended hours on a Wednesday evening to ensure services were accessible, flexible and offered continuity of care.

• The practice offered online services to request a repeat prescription and book an appointment.

• A range of health promotion and screening that reflects the needs for this age group were also offered.

• An automated arrival machine was available to give patients the opportunity to arrive themselves for their appointment rather than speak to a receptionist.

• 81% of women aged 25 to 64 medical notes recorded they had a cervical screening test performed in the preceding five years. This was comparable to the national average of 82%.

Updated 9 August 2016

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

• 84% of patients with a diagnosis of dementia had their care reviewed in a face-to-face review, which was comparable to the national average of 84%.

• 95% of those with a diagnosis of schizophrenia, bipolar affective disorder or other had a comprehensive and agreed care plan in place, which was better than the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health.

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Staff had a good understanding of how to support patients with mental health needs and those living with dementia.

• The practice hosted Improving Access to Psychological Therapies (IAPT) clinics on a weekly basis.

Updated 9 August 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.

• Home visits were offered to patients living in vulnerable circumstances and could not access the practice.

• 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. There were alerts on patient care records to alert clinicians of specific needs of vulnerable families and children.

• All staff had received safeguarding children and adults training.