St George's Medical Centre PMS Practice

Updated 22 November 2017

St George's Medical Centre PMS Practice is located on the outskirts of Barnsley. The building is an NHS LIFT building with good parking facilities and disabled access.

The practice is registered with the CQC to provide primary care services. The practice provides primary care services for approximately 6,759 (3,374 male, 3,385 female) patients under a Primary Medical Services (PMS) contract with NHS England in the Barnsley Clinical Commissioning Group (CCG) area. (The PMS contract is a contract between a general practices and NHS England for delivering primary care services to local communities.)

The practice has a higher level of deprivation (A score of three. The lower the level of Multiple Deprivation (IMD) decile the more deprived an area is.) An area itself is not deprived: it is the circumstances and lifestyles of the people living there that affect its deprivation score. Information collated by Public Health England in 2015/2016 shows over 50% of people have long-standing health conditions.

The practice has a three GPs (two male and one female), an advanced nurse practitioner, two nurses, one health care assistant and one phlebotomist working at the practice. They are supported administration and reception staff.

The practice is open Monday and Friday 8am to 6.30pm and Tuesday, on Wednesday and Thursday it opens earlier at 7am to 6.30pm.

When the practice is closed, telephone callers to St George’s medical centre PMS practice are asked to call NHS 111 and they will direct the patient to the appropriate service which could be GP Surgery next day, A&E, iHeart Barnsley and Out of Hours provided also by iHeart Barnsley. This service is commissioned by Barnsley Clinical Commissioning Group.

St George's Medical Centre PMS Practice was previously inspected by CQC on the 2 December 2014 where the overall quality rating for the practice was found to be Good.

Updated 22 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Georges Medical Centre PMS practice on the 17 October 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Staff were aware of current evidence based guidance.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• 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 areas where the provider should make improvement are:

• Review the system for updating medication Patient Group Directives, (PGD) to ensure they are correctly signed at the correct time by all staff.
• Liaise with NHS property services to ensure the premises used to care for and treat patients comply with the estates, and facilities alert regarding window blinds with looped cords or chains. (REF: EAF/2010/007 Issued 8 July 2010). The manager took action to ensure patient safety on the day of the inspection.
• Review the arrangements for disposal of  controlled drugs.
• Review the complaints procedure to ensure it contains the details of the Parliamentary and Health Service Ombudsman and investigation notes are retained.
• Ensure the Duty of Candour is incorporated into the practices policies and incident forms. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 22 November 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was 75%, which was similar to the CCG average of 76% and the national average of 78%.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• To try to prevent readmission, patients who have been admitted to hospital with exacerbation of chronic obstructive airways are seen within 2 weeks in the practice to ensure they have a care plan in place, a medication and condition review.
• All these patients had a named GP and there was a system to recall patients for 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 22 November 2017

The practice is rated as good for the care of families, children and young people.

• Childhood immunisations were carried out in line with the national childhood vaccination programme. Uptake rates for the vaccines given were comparable to CCG/national averages. For example, rates for the vaccines given to under two year olds ranged from 75% to 94% and five year olds from 91% to 96%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

Updated 22 November 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population. All staff had attended dementia awareness training and the practice had a dementia champion who kept up to date with local resources.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

Updated 22 November 2017

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

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours from 7am on a Tuesday, Wednesday and Friday.
• 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.
• All staff were aware that when an urgent appointment is requested for a child, that priority is given and they will be seen as extra if all other appointments are fully booked.

Updated 22 November 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 96% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months which was better than the CCG average of 86% and the national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment. The practice had a dementia champion, (A member of staff who kept upto date with local support for people with dementia).
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations. The dementia champion had contacted patients and carersto inform them of a new local dementia support group.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia. All staff had dementia awareness training.

Updated 22 November 2017

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, travellers and those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.