Archived: Dunsville Medical Centre

Updated 16 August 2016

Dunsville Medical Centre is located in Dunsville on the outskirts of Doncaster. The practice provides services for 5,267 patients under the terms of the NHS Personal Medical Services contract. The practice catchment area is classed as within the group of the fifth less deprived areas in England. The age profile of the practice population is similar to other GP practices in the Doncaster Clinical Commissioning Group (CCG)

The practice has three GP partners, two male and one female. They are supported by a two practice nurses, a healthcare assistant a practice manager and a team of reception and administrative staff.

The practice is open between 8am to 6pm Monday to Friday. Early morning appointments are available from 8am with GPs three mornings a week. Appointments with GPs, practice nursing staff and the healthcare assistants are available during the opening hours. A phlebotomy service with the healthcare assistant is available daily. In addition to pre-bookable appointments that could be booked up to two weeks in advance with a GP and six weeks in advance with a practice nurse, urgent appointments were also available for people that needed them.

When the practice is closed calls were answered by the out-of-hours service which is accessed via the surgery telephone number or by calling the NHS 111 service.

As part of the Care Quality Commission (Registration) Regulations 2009: Regulation 15 we noted GP partners registered with the Care Quality Commission as the partnership did not reflect the GP partners currently at the practice. We were told this would be addressed following the inspection and the appropriate applications and notifications submitted.

Updated 16 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dunsville Medical Centre on 5 July 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.
• Risks to patients were assessed and well managed.

• 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.

We saw one area of outstanding practice:

• The practice reduced the number of addictive medicines it prescribed by introducing protocols within the patient record system for some high risk medicines. By completing the protocol a full assessment of the patient was undertaken and it ensured appropriate prescribing.

The areas where the provider should make improvement are: 

• Review the quality outcomes framework exception reporting rates to ensure patients excluded meet the practice criteria.
• Report and investigate all types of incident as part of the incident reporting process.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 16 August 2016

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

• Practice nursing staff had lead roles in long term condition review and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was 4% above the CCG average and 11% above the national average.
• 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.

Updated 16 August 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 accident and emergency 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 79%, which was below the CCG average of 82% and the national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 16 August 2016

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

• All older patients had a named GP.
• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• A named GP took the lead for the nursing and residential homes allocated to the practice. They held a weekly clinic at the home incorporating medication and long term condition reviews along with regular appointments. They used laptops to record the consultations directly onto the patient record.

Updated 16 August 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.

Updated 16 August 2016

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

• Of those experiencing severe poor mental health 92% had a comprehensive care plan in place which was higher than the CCG average of 89% and the national average of 88%.

• 90% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice carried out advance care planning for patients living 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 16 August 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 those with a learning disability.
• The practice offered longer appointments for those who needed them.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed people how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in 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.