Vernon Street Medical Centre Also known as Dr P W Iddon and Partners

Updated 15 September 2016

Vernon Street Medical Centre provides primary medical services to approximately 9850 patients through a general medical services contract (GMS).

Services are provided from a main surgery; Vernon Street Medical Centre, 13 Vernon Street, Derby, DE1 1FW. Vernon Street Medical Centre is located in a Grade II listed building and has occupied its current premises since the 1950s. Primary medical services are provided from two floors within the building and there is lift access to the first floor.

Services are also provided from a branch surgery; The Lanes Medical Centre, 147 Normanton Lane, Littleover, Derby, DE23 6LF. The Lane Medical Centre was opened in 2008 replacing previous temporary accommodation. We did not visit the branch surgery as part of our inspection.

The level of deprivation within the practice population is similar to the national average with the practice population falling into the fifth most deprived decile. Income deprivation affecting children and older people is marginally above the national average.

The clinical team comprises six GP partners (one male, five female), two pharmacists (one full time equivalent directly employed by the practice), three practice nurses (female) and two healthcare assistants (female).

The clinical team is supported by a full time practice manager, an assistant practice manager an office manager and a team of reception and administrative staff.

The main surgery opens from 8.30am to 6.30pm Monday to Friday. Consulting times are from 8.30 to 11.00 each morning and from 2.30pm to 5.30pm each afternoon. Consultation times at the branch surgery are the same as the main surgery with the exception of Wednesday afternoons when the branch practice is closed.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United (DHU) and is accessed via 111.

The practice has identified that they are not currently registered to provide maternity and midwifery services as a regulated activity but are in the process of applying to add this regulated activity to their registration.

Updated 15 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Vernon Street Medical Centre on 22 July 2016. Overall the practice is rated as good.

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

• The practice demonstrated an open and transparent approach to safety. There were systems in place to enable staff to report and record significant events. Learning from significant events was shared.
• Risks to patients were assessed and well managed. A health and safety action plan was in place and risks were monitored on an ongoing basis.
• Staff delivered care and treatment in line with evidence based guidance and local guidelines. Training had been provided for staff to ensure they had the skills and knowledge required to deliver effective care and treatment for patients.
• Clinical audits were undertaken and showed improvements in the quality of care provided to patients.
• Feedback from patients was that they were treated with kindness, dignity and respect and were involved in decisions about their care.
• 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.
• The practice proactively sought feedback from patients through the use of surveys and via the NHS Friends and Family Test.
• Patients said they could generally get appointments when they needed one. There were systems in place to monitor demand for appointments and the practice continually sought to improve access for patients. A new telephone system was being installed in response to patient feedback.
• There was a clear leadership structure which all staff were aware of. Staff told us they felt supported by the partners and management.
• There was a clear vision and mission which was shared with patients on the website and throughout the practice.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• The provider should ensure that their business continuity plan is updated to formalise arrangements for dealing with major incidents or emergencies
• The provider should strengthen their system to record actions taken to address infection control issues.

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.

• Clinical staff had lead roles in managing patients with long-term conditions and those patients identified as being at risk of admission to hospital were identified as a priority.
• Performance for diabetes related indicators was 99.97% which was 6.9% above the CCG average and 10.8% above the national average.
• Longer appointments and home visits were available when needed to facilitate access for these patients.
• All these patients had a named GP and were offered regular reviews to check their health and medicines needs were being met.
• For patients with the most complex needs, the named GP worked with relevant health and social care professionals to deliver a multidisciplinary package of care.
• Patients with multiple long-term conditions were reviewed at one appointment where possible.

Updated 15 September 2016

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

• Systems were in place to identify children at risk. The practice had a dedicated child safeguarding lead and staff were aware of who this was. The practice was working with the health visitor to strengthen links including inviting the health visitor to attend their regular community support team meetings.
• Vaccination rates for childhood immunisations were in line with local averages.
• Patients told us that children and young people were treated in an age-appropriate way and treated as individuals and the premises were suitable for children.
• Maternity services and baby checks were provided at the practice. Patients could access midwife services from the practice.
• One of the GP partners sat on the paediatric clinical improvement group for the clinical commission group (CCG) and contributed to the development of local care and referral pathways.

Updated 15 September 2016

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

• Personalised care was offered by the practice to meet the needs of its older population. The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Longer appointments were also provided for older people on request.
• The nursing team visited patients who were housebound to facilitate long-term condition reviews at home.
• Services were provided to a number of older people in nursing homes. Ward rounds were undertaken monthly to ensure patients were regularly reviewed. This work was supported by the practice pharmacists who undertook care home medication reviews. Feedback from one of the nursing homes covered by the practice was positive about the level of engagement demonstrated by the practice.
• Pharmacists undertook medication reviews for older patients to ensure appropriate monitoring of patients taking multiple medicines.

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 offered services which were accessible and flexible. For example the practice had introduced telephone triage to enable patients who could not get appointments to speak with a GP via telephone.
• The practice was proactive in offering online services including appointment booking and online prescription services.
• A range of health promotion and screening services were offered and promoted that reflected the needs of this age group. Uptake rates for cervical cancer screening, bowel cancer screening and breast cancer screening were in line with local and national averages.
• A range of services were offered at the practice to facilitate patient access including minor surgery and joint injections.
• Wireless internet services were provided within the practice.

Updated 15 September 2016

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

• Performance for mental health related indicators was 100% which was 3.1% above the CCG average and 7.2% above the national average.
• 79.2% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was 6.2% below the CCG average and 4.8% below the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice 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.

Updated 15 September 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice nurses and healthcare assistants undertook home visits for patients who were housebound to ensure they received a range of services.
• Information was available which informed vulnerable patients about how to access local and national support groups and voluntary organisations.
• Translation services were provided where these were required.
• In order to effectively support vulnerable patients, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care. Community support team meetings were held every six weeks.
• 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. Safeguarding concerns were regularly discussed at the weekly multidisciplinary meetings.
• The practice had identified 6% of their patient list as carers and offered support including annual flu vaccinations.