Minster Medical Practice

Updated 7 January 2016

Minster Medical Practice is a four partnership practice in a purpose built semi detached building, the Cabourne Court Health Care Complex. The practice list size is approximately 10,000 patients. The site has ample car parking and pedestrian access. Other services on the site include a Chemist, Dental Practice, Physiotherapy clinic, Chiropractor, Chiropodist and Hearing Care Aid Centre.

The practice area covers uphill Lincoln and the local villages.

The practice is a GP training practice. The practice had one trainee GP on the day of the inspection. Trainee GPs are fully qualified doctors who already have experience of hospital medicines and gain valuable experience by being based within the practice. They work full-time in the practice for a period of four or 12 months dependent upon the stage of training they are at.

The practice provides GP services under a (GMS) General Medical Services contract.

Both male and female life expectancy was in line with the national average.

The practice has four GP partners, one salaried GP, one Nurse Practitioner, three Practice Nurses, one Healthcare Assistant and one Phlebotomist alongside a practice manager and 13 reception/administration staff.

The surgery is open from 8am until 6.30pm Monday to Friday. Appointments are available from 8.30am to 11.30am and from 2pm until 6pm.

The practice lies within the NHS Lincolnshire West Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

The practice had not previously been inspected by the Care Quality Commission.

Updated 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Minster Medical Practice on 27 August 2015.

Overall the practice is rated as good.

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

• Urgent appointments were available the same day.
• The practice had good facilities including disabled access and was found to be clean and tidy.
• Information about services and how to complain was available.
• Patients said they felt the practice offered an excellent service and staff were friendly and caring and treated them with dignity and respect
• There were systems in place to reduce risks to patient safety for example, infection control procedures.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles.
• Recruitment checks were carried out and the appropriate recruitment checks had been undertaken prior to employment.
• The practice had a comprehensive business continuity plan in place for major incidents such as power failure or building damage.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

• Complaints were managed and dealt with effectively however no annual review had taken place and staff were not informed of complaints unless they were involved.

However there were areas where the provider should make improvements.

Importantly the provider should:

• Ensure a patient participation group (PPG) is in operation.
• Have a regular review of complaints and SEAs to identify trends.
• Have a system in place to regularly identify and manage the risk of health care associated infections.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 January 2016

The practice is rated as good for the care of people with long-term conditions. GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All patients had a named GP and a structured annual review to check that their health and medication needs were being met. Patients were encouraged to manage their conditions and were referred to health education and other services such as weight watchers and smoking cessation.  Special notes were used on the patient record enabling out of hours providers to be informed of any special information they may need in relation to these patients outside normal surgery hours.

Updated 7 January 2016

The practice is rated 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. The practice met with a health visitor on a monthly basis to discuss any safeguarding issues. The clinical system also enabled communication between GPs, nurses and health visitors. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 7 January 2016

The practice is rated good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.  The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits, if necessary as well as same day appointments if needed. Every patient had a named GP. The practice had contact with district nurses and participated in monthly meetings with other healthcare professionals to discuss any concerns.

Updated 7 January 2016

The practice is rated good for the care of working-age people (including those recently retired and students). The practice did not offer appointments out of normal hours however patients were always able to get an appointment on the day and the patient feedback did not suggest that this was an issue. The practice also offered telephone consultations with a clinician if requested and also offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 7 January 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). 94% of people experiencing poor mental health had received an annual review. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 7 January 2016

The practice is rated 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. It had carried out annual health checks and longer appointments were available for people with a learning disability. Staff had been trained 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.