Gosberton Medical Centre

Updated 15 November 2016

Gosberton Medical Centre is a GP practice, which provides primary medical services to approximately 6,449 patients predominately living in Gosberton and surrounding areas. All patient facilities are accessible. South Lincolnshire Clinical Commissioning Group (SLCCG) commission the practice’s services.

The practice has three GP partners (male). The nursing team consists of an advanced nurse practitioner (also a partner), four practice nurses and four health care assistants. The dispensary consists of a medicines manager, five dispensers, two dispensary assistants and two delivery drivers. They are supported by a Practice Manager and a team of administrative and reception staff.

The practice is open between 8am and 6.30pm Monday to Friday. Extended hours appointments are offered between 7.30am and 8am on Mondays and Tuesdays. Urgent appointments and telephone consultations are also available for people that need them.

The dispensary is open between 8am and 6.30pm Monday to Friday.

The practice also offers a minor illness service which patients can ring on the day and book into.

Patients can also access out of hours support from the national advice service NHS 111. The practice also provides details for the nearest walk-in centre, as well as accident and emergency departments.

The practice is an approved training practice.

Updated 15 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gosberton Medical Centre on 27 September 2016. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events and lessons were shared to make sure action was taken to improve safety in the practice.

• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

• The practice was signed up to the Dispensary Services Quality Scheme (DSQS) and carried out an annual audit in line with the requirements of the DSQS.

• Risks to patients were assessed and well managed.

• A business continuity plan was in place in the event of a major disruption to the service.

• Medicines and Healthcare related products Regulatory Agency (MHRA) alerts and new and amended NICE guidance were discussed at regular clinical meetings. The practice audited current practice against new guidance and took action to improve the service provided.

• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average.

• Clinical audits demonstrated quality improvement in patients’ care.

• Staff worked together and with other health and social care professionals to understand and meet the range and complexity of patients’ needs and to assess and plan ongoing care and treatment.

• All staff had undergone training in the Mental Capacity Act 2005.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• There was evidence of appraisals and personal development plans for all staff.

• Patients said they felt the practice offered an excellent service and staff were respectful and caring.

• Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care.

• Information for patients about the services available was easy to understand and accessible.

• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

• The practice were proactive and had a good process in place to identify carers and provided additional support as appropriate.

• Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified.

• Most patient feedback said they were able to get an appointment when they needed one. The practice had good facilities and was well equipped to treat patients and meet their needs.

• Information about how to complain was available and easy to understand and evidence showed the practice responded to issues raised.

• A business plan was in place which outlined the short-term and long-term goals of the practice, which underpinned the vision.

• There was a clear leadership structure and staff felt supported by management.

• The practice had a clear meeting structure to ensure information was discussed at relevant meetings in a timely manner.

• There was an overarching governance framework which supported the delivery of the strategy and good quality care.

• The practice proactively sought feedback from staff and patients, which it acted on.

• There was an established patient participation group which was active within the practice.

The areas where the provider should make improvement are:

• Consider appointing a fire lead with appropriate training.

• Consider and review the current process to investigate complaints to identify the root cause.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 November 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.

• 88% of those diagnosed with diabetes had a blood test to assess diabetes control (looking at how blood sugar levels have been averaging over recent weeks) compared to the national average of 78%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and were offered 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 15 November 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.

• 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 15 November 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.

• A weekly ward round was carried out at a local nursing home where some patients resided.

Updated 15 November 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 a full range of health promotion and screening that reflects the needs for this age group.

Updated 15 November 2016

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

• 94% of those with a diagnosis of schizophrenia, bipolar affective disorder or other had a comprehensive and agreed care plan in place, compared to the national average of 88%.

• 96% of patients with a diagnosis of dementia had their care reviewed in a face-to-face review, compared to 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 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 15 November 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 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.