Dr Black & Partners

Updated 26 September 2017

Dr Black & Partners provides primary medical services to approximately 14,800 patients via a General Medical Services (GMS) contract commissioned by NHS England and NHS Southern Derbyshire Clinical Commissioning Group. Patients can access services across two sites. The main location is Chellaston Medical Centre which is situated in Rowallan Way, Chellaston, Derby, DE73 5BG. The branch surgery is Melbourne Medical Centre which is situated in Penn Lane, Melbourne, Derby, DE73 8EF.

We visited the main location during our inspection. The practice operates from purpose-built premises and all patient services are provided on the ground floor of the building, whilst the upper floor is utilised for administration.

The practice is run by a partnership of five GPs (three females and two males). The partners employed two salaried GPs (male and female) at the time our inspection. A third salaried GP is scheduled to commence their role on 21 August 2017. The GPs are supported by:

• A clinical pharmacist, a practice nurse, three urgent care practitioners and a health care assistant. All of the clinical staff work across the two surgeries.

• The clinical team is supported by a practice manager and a team of reception and administrative staff.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments at both practices are generally available from 8.30am to 11.30am and 3.30pm to 5.30pm daily.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United (DHU) and is accessed via 111.

Updated 26 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Black & Partners on 14 June 2016. The overall rating for the practice was good, but it was rated as ‘requires improvement’ for providing safe services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Dr Black & Partners on our website at www.cqc.org.uk.

We carried out an announced focused inspection on 14 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 14 June 2016. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• Improvements had been made to the systems and processes in place which was highlighted following our initial inspection. Specifically the arrangements for delivering safe care and treatment.
• The practice had clearly defined and embedded systems to ensure clinical oversight of medicine management processes to support the safe issue of prescriptions.
• Risks to patients and staff were assessed and well managed. This included fire safety, management of legionella, and health and safety.
• The practice had a comprehensive business continuity plan for major incidents and copies of the plan were held off site.

The areas where the provider should make improvement are:

• Ensure additional member(s) of staff are identified and trained to carry out the weekly testing of fire safety arrangements to support the responsible person in their absence.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 August 2016

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

• There was a GP who was the lead for QOF and supported the practice in monitoring achievement. All GPs were responsible for providing chronic disease management and those patients who were at risk of hospital admission were identified as a priority and reviewed regularly.
• The urgent care practitioners were available to review patients who had an acute exacerbation of their condition between visits.
• The practice had achieved 98.2% of the total QOF points available for diabetes related indicators which was 5.1% above the CCG average and 9% above the national average. Exception reporting rates were similar to C CG and national averages.
• 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 15 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 protection plans in place.
• Children who had not attended appointments were followed up by a dedicated administration lead, and where non-attendance continued, reported to the GP who acted as the child safeguarding lead. The practice worked with the health visiting team to encourage attendance.
• There were regular midwifery clinics and new mothers were offered post-natal checks and development checks for their babies
• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children.
• There were vaccination programmes in place and the practice indicators were comparable with the local Clinical Commissioning Group averages.

Updated 15 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. All had a named GP.
• There was a nominated GP who made weekly ward round visits to their patients in local care homes and had meetings with staff there to discuss care
• The practice was responsive to the needs of older people, and offered home visits, telephone consultations and urgent appointments for those with enhanced needs.
• The practice regularly reviewed any unplanned admissions and ensured that care plans were updated and shared with relevant health professionals.
• The practice had good links with local pharmacies and supported a delivery service to patients who were housebound.

Updated 15 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 had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• A range of on-line services were available, including medication requests, booking of GP appointments and access to health medical records.
• The practice offered all patients aged 40 to 74 years old a health check with the nursing team.
• Telephone appointments were available for medicine reviews
• Telephone consultations were available with a nurse or GP

• The practice provided information about health promotion and screening that reflected the needs for this age group. For example; breast screening, bowel cancer screening and cervical smear tests. There was a named administrator who invited eligible patients for cytology screening (cervical smears)

Updated 15 August 2016

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

• The practice held a number of appointment slots each day for Patients who presented with an acute mental health crisis were offered same day appointments. People experiencing poor mental health were offered an annual physical health check. Dementia screening was offered to patients identified in the at risk groups. GPs carried out advance care planning for patients with dementia.
• The practice had regular multi-disciplinary meetings with other health professionals in the case management of patients with mental health needs and dementia, and followed up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• The practice had 134 patients on their dementia register and 99.1% of them had their care reviewed in a face to face meeting in the last 12 months, which is higher than both CCG and national averages.
• The practice had achieved 100% of the total QOF points available for mental health related indicators. This was 3.1% above CCG average and 7% above the national average. However, exception reporting was higher than CCG and national averages for some mental health related indicators. We looked at patient records and found that the high exception reporting was due to patients being included in the report where they had been in remission and had adversely affected the score.
• 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 dementia.

Updated 15 August 2016

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

• The practice enabled all patients to access their GP services and assisted those with hearing and sight difficulties. There was a member of staff who used sign language when requested. A translation service was available for non-English speaking patients. There were automated entrance doors and toilets were suitable for disabled patients.
• The practice held a register of patients with a learning disability and had developed individual care plans for each patient. Out of 61 patients on the learning disabilities register, 40% had received annual health checks in the preceding 12 months. Longer appointments were offered for patients with a learning disability and carers were encouraged by GPs to be involved with care planning.
• The practice had a register of vulnerable patients and displayed information 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.
• Carers were viewed by the practice as vulnerable patients and were offered an annual health review and information about how to get support.
• The practice held monthly meetings with a care coordinator to review the needs of all patients on their registers who may be at risk or considered vulnerable. Meetings included representatives from the community support staff and social team.