Archived: Trentside Medical Group Also known as Netherfield Medical Centre

Updated 18 April 2016

Trentside Medical Group is located in Netherfield, a small town three miles east of Nottingham. The practice provides services for approximately 11,650 patients. There are areas of deprivation within the locality of the practice. The practice told us that they care for a high number of unemployed people, single parent families, patients with mental health problems and long term conditions such as those with lung diseases. The practice locality is within an ex mining area. They also told us that there are a high number of rental properties within the area which means a number of patients move in and out of the area more frequently.

The practice holds a Personal Medical Services contract (PMS) which is a locally agreed contract between NHS England and a GP to deliver care to the public. The practice provides GP services commissioned by NHS Nottingham North and East Clinical Commissioning Group (CCG).

The practice has a branch surgery located at Colwick. We did not visit the practice’s branch surgery as part of this inspection.

The practice is managed by five GP partners. Three of the partners are male, working full time and two are female partners who work in part time roles. (0.75 Whole Time Equivalent, WTE) They are supported by clinical staff; two female salaried GPs who work in part time roles, (both 0.59 WTE) two female advanced nurse practitioners, four practice nurses, two female healthcare assistants, and one male phlebotomist / trainee healthcare assistant. The practice also employs a practice management team which includes a business director, office supervisor and book keeper and a team of reception, clerical and administrative staff.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 7am to 6.30pm on Mondays, 8am to 6.30pm on Tuesdays, 7am to 7pm on Wednesdays, 7am to 6.30pm on Thursdays and 7am to 6.30pm on Fridays. The practice is closed during weekends. Urgent appointments are available on the day. Routine appointments can be pre booked in advance in person, by telephone or online. Telephone consultations and home visits are available daily as required. The practice also gives priority to sick children by offering dedicated lunch time appointments.

The practice has opted out of providing GP services to patients out of hours such as nights and weekends. During these times GP services are provided currently by Nottingham Emergency Medical Services. When the practice is closed, there is a recorded message giving the out of hours details.

The practice was a teaching practice for medical students.

The practice’s Certificate of Registration issued by the Care Quality Commission lists three partnership members. We found that two other partners were working within the Practice. The Care Quality Commission (Registration) Regulations 2009 state that notice must be given to the Commission of any change in the membership of the partnership as soon as it is reasonably practicable to do so.

Updated 18 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Trentside Medical Group on 3 November 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Opportunities for learning were always considered and the practice adopted a candid and open approach.
• Risks to patients were assessed and well managed. This included staff and patient health and safety.
• Clinical audits had been carried out which demonstrated improved patient outcomes. One of the examples provided was a completed audit cycle.
• The majority of patients told us they were treated with compassion, dignity and respect. A wide variety of information and support services were made available to the public.
• The practice had offered extended hours appointments and had demonstrated flexibility in response to increasing patient demand. However, patient feedback indicated that further measures were required so patients could more easily access the service and appointments.
• The practice had a number of policies and procedures to govern activity. Policies were reviewed, updated and accessible by staff.
• The practice had sought feedback from patients and had an active patient participation group.

The areas where the provider should make improvement are:

• Ensure that all staff have understanding of roles and responsibilities under the Mental Capacity Act 2005.

• Ensure safeguarding training is undertaken by all clinical staff within the practice and all staff are aware of their duties and responsibilities in relation to identifying and reporting potential safeguarding concerns.

• Ensure that the use of prescription pads is monitored within the practice.

• Ensure that all staff undertaking chaperone duties receive formalised training to undertake their role.

• Records of action plans should be held when regular audits in infection control are undertaken.

• Ensure the management of staff training and record keeping in relation to the programme is strengthened.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 April 2016

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

• GPs and advanced nurse practitioners had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. For those people with the most complex needs, the named GP and nurse practitioners worked with the relevant health and care professionals to deliver a multidisciplinary package of care. Longer appointments and home visits were available when needed.

• GPs provided clinical support where required to nursing staff who had roles in treating patients with long term conditions.

• The practice had recall systems in place for those patients with a long term condition.

Updated 18 April 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 A&E attendances.

• We saw detailed records of joint working with midwives and health visitors. Meetings were held regularly to discuss risks to vulnerable patients.

• Immunisation rates were relatively high for all standard childhood immunisations and were in line with local averages.

• Whilst appointments were considered to be difficult to access at times, priority was given to sick children. These included lunch time appointments with the practice medical team. Appointments were also available outside of school hours and the premises were suitable for children and babies.

• The practice had attended a local comprehensive school in June 2015 to promote health awareness to students.

Updated 18 April 2016

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

• The practice had 757 patients aged over 75 on its register. The practice annually reviewed the records of patients not recently seen and checked if there were any health concerns which required patient contact. The practice had seen 734 elderly patients this year.

• Nationally reported data showed that outcomes for patients with conditions commonly found in older people such as osteoporosis were good and were significantly above the local and national averages.

• The practice had proactively engaged with the community care homes team nurse who regularly monitored the health needs of practice patients living in residential care homes.

• A care homes pharmacist employed by the CCG had started working with the practice to ensure safe and cost effective care home prescribing.

• The practice offered home visits and priority appointments for those with enhanced needs.

Updated 18 April 2016

The practice is rated as good for the care of working-age people (including those recently retired and students)

• The age profile of patients at the practice in 2015 mainly comprised of working age persons 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 try and ensure these were accessible, flexible and offered continuity of care. Extended hours surgery was offered on weekdays which included appointments ranging from 7am to 7pm. Telephone triage appointments were also offered so that patients’ health problems could be discussed. This negated the need for some patients to attend the practice for face to face consultations.

Updated 18 April 2016

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

• The practice had attended two community events with the Alzheimer’s Society which offered education to healthcare staff and carers of patients with dementia.

• Alzheimer’s Society and Age UK had stalls on a monthly basis in the waiting room at the practice.

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

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

• The practice also encouraged those patients with mild to moderate mental health difficulties to self-refer to a therapy programme, Improving Access to Psychological Therapies (IAPT)

Updated 18 April 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. There were 22 patients with severe learning disabilities and nine of these had received a health review, with the remainder planned for January to March 2016.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told vulnerable patients about how to access various support groups and voluntary organisations. The practice had referred a number of patients to a crisis intervention community support service run by the Red Cross. Information was also displayed within the practice waiting area.

• Most staff knew how to recognise signs of abuse in vulnerable adults and children. GPs 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.