Hibaldstow Medical Practice

Updated 5 July 2016

The Hibaldstow Medical Practice provides primary medical services to approximately 3,338 patients in and surrounding the village of Hibaldstow, Lincolnshire. The practice has a dispensary on site with a dispensary manager and a dispensary assistant.

It is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning, maternity and midwifery services and surgical procedures.

At the time of our inspection the practice employed three GPs, two practice nurses, one health care assistant (HCA)/receptionist, two receptionists, a dispensary manager and a dispenser. They are supported by a practice manager. The surgery is open from 8.30am to 6.30pm Monday to Friday.

The practice has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering care services to local communities.

The practice has one location registered with the Care Quality Commission (CQC) which is The Hibaldstow Medical Practice, 11 Church Street, Brigg, DN20 9ED.

The practice has a higher population of patients between the ages of 44-79 years of age. 60.3% of the practice patient population has a long standing health condition which is higher than the CCG average of 55.9% and national average of 54%. The practice had a low ethnicity rate, 1.2% of the patient population were non-white ethnic groups.

The practice offers on-line services for patients including ordering repeat prescriptions and booking routine appointments.

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.

Updated 5 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Hibaldstow Medical Practice on 17 March 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.

• Most risks to patients were assessed and well managed with the exception of a fire risk assessment which required review.

• 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.

The areas where the provider should make improvement are:

• Ensure regular fire drills are carried out and appropriate records are held.

• Ensure an up to date fire risk assessment is in place.

• Ensure all policies and procedures are reviewed and updated.

• Ensure dispensary staff are invited to attend clinical meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 July 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.

• Performance for diabetes related indicators was 92% which was better than the national average of 89.2%.

• 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.

• The practice offered combined health visitor and practice nurse baby clinics with a GP in attendance. These clinics were to provide a combined appointment to include 6-8 week baby check, first baby immunisations and an additional appointment for a post-natal check for the mother.This reduced the number of visits required to the practice.

Updated 5 July 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.

• The practice’s uptake for the cervical screening programme was 80.1%, which was higher than the CCG average of 77.7% and the national average of 74%.

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

• The practice provided smoking cessation advice clinics.

• We saw positive examples of joint working with midwives, health visitors and school nurses. The practice offered combined health visitor and practice nurse baby clinics with a GP in attendance. These clinics were to provide a combined appointment to include 6-8 week baby check, first baby immunisations and an additional appointment for a post-natal check for the mother.This reduced the number of visits required to the practice.

• Childhood immunisation rates for the vaccinations given were comparable to CCG/national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds was 100% and five year olds from 87.5% to 100%.

Updated 5 July 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 5 July 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.

• 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.

• The practice provided an automated system for patients called ‘patient partner’. This system enabled patients to book, cancel or change appointment times by an automated telephone system. The system also enabled patients to order repeat prescriptions using the same automated service.
• The practice offered telephone consultations for patients who were unable to attend for an appointment.

Updated 5 July 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 90.8% which was lower than the national average of 92.8%.

• 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 5 July 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, travellers and those with a learning disability.

• 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 informed 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.

• The practice provided a weekly medication delivery service from its dispensary to patients who found it difficult to access the surgery such as patients with poor mobility. This service also ensured the practice had regular contact with vulnerable patients.