Archived: Craven Arms Medical Practice

Updated 23 July 2015

Craven Arms Medical Practice is located in Shropshire and provides primary health care to patients living in Craven Arms and the surrounding villages. The practice holds a General Medical Services (GMS) contract with NHS England.

The practice provides a number of specialist clinics and services. For example long term condition management including asthma, diabetes and high blood pressure. It also offers services for family planning, immunisations, health checks, travel health and minor surgery. It also offers a phlebotomy service. Phlebotomy is the taking of blood from a vein for diagnostic tests.

A team of two GP partners, one salaried GP, three practice nurses, two phlebotomists and three pharmacy dispensers provide care and treatment for approximately 3893 patients. There is also a practice manager, six receptionists and administrative staff. There are two male and one female GP.

The practice is open between 8.30am until 1pm and 2pm until 6pm Monday, Tuesday, Thursday and the second and fourth Wednesday of each month. The practice opens later, 9.30am on a Friday, and closes earlier, 5 pm on the first and third Wednesday of each month. The practice does not routinely provide an out-of-hours service to their own patients but patients are directed to the out of hours service, Shropdoc when the practice is closed.

Updated 23 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Craven Arms Medical Practice on 15 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led, services. It was also good for providing services for older people; people with long-term conditions; families, children and young people; working age people; people whose circumstances may make them vulnerable and people experiencing poor mental health.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that 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.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Review significant events over time to identify any themes or trends.
• Consider recording information about children with protection plans within the parent /guardian electronic patient record.
• Ensure all staff who act as chaperones have received appropriate training.
• Carry out a risk assessment to ensure the safety of confidential information within the practice.
• Carry out a risk assessment to ensure the safety of medicine storage in the reception area.
• Ensure all necessary pre-employment checks are obtained and appropriate information kept on file.
• Complete the process of obtaining Disclosure and Barring Service checks for clinical staff.
• Complete the process of carrying out risk assessments or Disclosure and Barring service checks on non-clinical staff who act as chaperones.
• Ensure patient confidentiality is maintained at the reception hatch.
• Share the practice’s aims with staff and patients.
• Develop a business plan to support delivery of the practice aims and any future developments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 July 2015

The practice is rated as good for the care of people with long-term conditions. We found that the nursing staff had the knowledge, skills and competency to respond to the needs of patients with a long term condition such as diabetes and asthma. Longer appointments and home visits were available when needed. All of these patients were offered a structured review to check that their health and medication needs were being met. For those people with the most complex needs, the GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care.

Updated 23 July 2015

The practice is rated as good for the care of people with long-term conditions. We found that the nursing staff had the knowledge, skills and competency to respond to the needs of patients with a long term condition such as diabetes and asthma. Longer appointments and home visits were available when needed. All of these patients were offered a structured review to check that their health and medication needs were being met. For those people with the most complex needs, the GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care.

Updated 23 July 2015

The practice is rated as good for the care of older people. Every patient over the age of 75 years had a named GP. The practice offered proactive, personalised care to meet the needs of the older people in its population. The practice had introduced the Compassionate Communities Project, which identified the isolated and lonely patients in the older population and matched them with volunteers to provide social interaction and support. It was responsive to the needs of older people and offered home visits as required. The practice identified if patients were also carers, and information about support groups was available in the waiting room.

Updated 23 July 2015

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. Although the practice did not offer extended hours, appointments were available up to 6pm and telephone consultations could be arranged. The practice offered all patients aged 40 to 75 years old a health check with the nursing team. Family planning services were provided by the practice for women of working age. Diagnostic tests, that reflected the needs of this age group, were carried out at the practice. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 23 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check. It carried out advance care planning for patients with dementia.

The practice had access to a range of services to support patients with mental health needs, a number of which were provided at the practice. Patients requiring for psychological support could be referred to the visiting counsellor. The local memory team provided support for patients and carers on a monthly basis. The community mental health nurse held fortnightly assessment.

Updated 23 July 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. We found that the practice enabled all patients to access their GP services. The practice held a register of patients with a learning disability and had developed individual care plans for each patient. The practice carried out annual health checks and offered longer appointments for patients with a learning disability.

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. 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.