Norfolk Street Surgery

Updated 15 September 2016

Norfolk Street Surgery is registered with CQC as a partnership provider operating out of modern purpose built premises in Shelton, Stoke on Trent.

The history of the practice can be traced back over 100 years. The most recent change was a move to the Shelton Primary Care Centre which houses two other GP practices and other NHS services.

The practice holds a General Medical Services contract with NHS England and has extended the provision of a number of additional services including:

• Minor Surgery

• A vasectomy service for practice and non-practice patients.

• Glucose Tolerance Testing for pregnant practice and non-practice female patients.

• Extended appointments.

• Health checks for patients with a learning disability.

At the time of our inspection the practice had 7,860 registered patients. The demographic of the practice does differ from average ranges in a number of areas that may increase the demand on a GP practice:

• The practice has 1.3% of patients who live in care homes compared to the clinical commissioning group (CCG) and national averages of 0.5%.

• The level of deprivation in the area affecting children is higher than both the CCG and national average. The practice has 7.3% of patients aged less than four years compared to the CCG average of 6.5% and national average of 5.9%.

• The level of deprivation in the area affecting older people is 30% compared to the CCG average of 20% and national average of 16%. The practice has 6% of patients aged 75 and over compared to the CCG and national averages of 8%.

The practice is open Monday to Friday from 8am to 6:30pm. During these times telephone lines and the reception desk is staffed and remained open. Extended hours appointments are offered on a Monday and Wednesday until 7:30pm. When the practice is closed patients can access help by telephoning the practice, after which their call is transferred to the NHS 111 service for assistance.

Staffing at the practice includes:

• Four GPs in partnership (three male, one female).

• Two GP registrars (one male, one female)

• A senior nurse prescriber (female) leads the nursing team of two additional practice nurses (one female, one male) and a female healthcare assistant.

• The practice manager, assisted by an assistant practice manager, oversees the operational delivery of services with a team of 11 administrative staff.

Updated 15 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Norfolk Street Surgery on 5 July 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 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 September 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.

• 73% of patients with asthma had received a review of their condition within the last year compared with the CCG average and national averages of 75%.

• 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 September 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. 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.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 15 September 2016

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

• The practice provided additional support for older patients, as they had identified that this group of patients were at the highest risk of unplanned admission to hospital.

• The practice offered enhanced health assessments to all patients aged 75 and over. The assessments took place at a place convenient to the patients’ needs and from April to June 2016 a total of 173 health assessments had taken place. A total of 30 patients had required additional follow up resulting from the assessment and this included referral to occupational therapists, falls prevention services and GPs.

• The number of patients who lived in care homes was nearly three times the local and national average. The practice provided proactive case reviews in patients who lived in care homes and we received highly positive feedback about the care provided.

Updated 15 September 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.

• Extended hours appointments with GPs and nurses were available until 7:30pm two evenings each week.

• 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 15 September 2016

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

• The practice regularly worked with multi-disciplinary 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.

Updated 15 September 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 had an arrangement with a number of local hostels to reach out and invite patients to register at the practice.

• The practice had recently commenced to offer all homeless patients an advanced health assessment.

• Shared care clinics were held twice a week to support patients with drug addiction.

• The practice offered longer appointments for patients with a learning disability. Annual health checks were offered and 90% of patients had received a recent health check.

• 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.