Oakenhall Medical Practice

Updated 6 September 2016

Oakenhall Medical Practice is located in Hucknall, a town in Nottinghamshire which is in the district of Ashfield. It is seven miles north-west of Nottingham. Whilst there is direct access to the practice by public transport, there is no on-site parking. Public car parking is available within walking distance of the practice.

The practice currently has a list size of approximately 7149 patients.

The practice holds a General Medical Services (GMS) contract which is a locally agreed contract between NHS England and a GP to deliver care to the public. The practice provides GP services commissioned by NHS Nottingham North and East CCG.

The practice is situated in an area with mid-average levels of deprivation. It has a higher than national average of working aged adults and older age population. A lower number of patients registered at the practice are working or in full time education compared with the local CCG average.

The practice is managed by four GPs (1 male, 3 female). The partners work on a part time basis and their hours worked equates to the practice having 3 full time GPs.

The GPs are supported by some regular locum doctors and other clinical staff; three female part time practice nurses, one male part time healthcare assistant. The practice also employs a practice manager and a team of reception, clerical and administrative staff.

The practice is a training practice for medical students and nurses.

The practice is open on Mondays to Fridays from 8am to 6.30pm. Appointments are available Mondays to Fridays 8am to 6.30pm. The practice does not offer extended hours access. The practice is closed during weekends.

The practice has opted out of providing GP services to patients out of hours such as nights and weekends. During these times GP services are currently provided by Nottingham Emergency Medical Services (NEMS). When the practice is closed, an answerphone message redirects callers to the out of hours service.

Updated 6 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oakenhall Medical Practice on 16 June 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. Learning outcomes were shared with staff.
• Risks to patients were assessed and well managed. These included systems to manage health and safety matters such as checking that equipment was working and safe to use and infection control measures.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Clinical audit helped to drive quality improvement. Staff had been trained and had 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. Patient feedback was positive regarding the standard of care received.
• 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.
• Whilst patients said access to appointments could be difficult, they also said they found it easy to make an appointment with a named GP. There was continuity of care, with urgent appointments available the same day including telephone consultations.
• The practice had good facilities and was 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:

• Take more proactive steps to improve QOF performance.

• Continue to review arrangements to address all the issues raised in the national patient survey, particularly in relation to access and reception staff helpfulness and attitude. The provider should assess whether measures taken have proved successful.

• Review the arrangements in reception to reduce the risk of conversations with patients being overheard.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 September 2016

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

• Nursing staff and GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority and action taken to reduce the likelihood of attendance.

• Data showed in 2014/15 that the practice was performing below local and national averages in a number of indicators including diabetes. For example, the practice had achieved 61% in diabetes indicators overall, which was under the CCG average of 87% and national average of 89%. The practice provided data for 2015/16 to show it had improved its performance to 73% in this area. The data provided had not yet been validated or published.

• A monthly clinic was available with a diabetic specialist nurse for initiation of insulin and review of patients with complex diabetes problems.

• Longer appointments and home visits were available when needed.

Updated 6 September 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 for all standard childhood immunisations ranged from 93% to 100%. This was comparable to CCG averages which ranged from 88% to 98%.

• 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.

• Appointments were available outside of school hours and the practice prioritised appointments for sick children.

• The practice had changed its computer system which improved communications with the health visiting team, school nurses and midwives. We saw examples which demonstrated joint working with these attached staff was effective.

Updated 6 September 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 cared for a higher elderly population group compared with the national average.

• The practice provided care to patients residing in nine residential care homes. Each of these homes had a named GP to ensure continuity of care for patients and to build a supportive relationship with care home management. Care home staff we spoke with told us they were happy with the services provided and the practice were responsive to requests for any additional visits required.

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

Updated 6 September 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice offered appointments on weekdays up until 6.30pm which enabled flexibility for working age patients, students and those recently retired to attend. Routine appointments were available for booking up to two weeks in advance.

• Working age patients were offered a telephone consultation with a GP on the same day of request if the patient could not attend for an appointment or one was not available.

• Nurse led clinics were available from 8am to 6.30pm on weekdays to enable working aged women to attend for cervical cytology.

• 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 6 September 2016

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

• Data from 2014/15 showed that 85% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was slightly lower than the CCG average of 88% and slightly higher than the national average of 84%. Exception reporting was 6.6% lower then the CCG average and 5.9% lower than national average. 

• Data from 2014/15 showed that 78% of patients with a mental health condition had a documented care plan in place in the previous 12 months. This was below the CCG average of 86% and below the national average of 88%. Exception reporting was 0.4% below CCG average and 5.6% above national average. We were provided with information from the practice which showed that overall performance for mental health indicators had improved in 2015/16. This data had not yet been validated or published.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations such as counselling services, the Samaritans and Focus Line.

Updated 6 September 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. For those patients who chose to attend with a carer, a flexible appointment time was provided. Appointments were allocated with the same GP to ensure continuity of care.

• The practice had 32 patients aged 14 or over on its learning disability health check register. (These had been validated with assistance of the Learning Disabilities Health Facilitator). Data provided by the practice showed 27 of these patients had been offered an annual health check and 26 had received one. 

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. Documentation supported that patients received ongoing care and support from the appropriate health care service(s).

• Care plans had been implemented for those identified as close to the end of their life. Data showed that in February 2016, 17 patients had these plans in place. The practice held regular multidisciplinary meetings where all patients who were vulnerable and requiring intervention were discussed with input from other care teams into their holistic care.

• The practice offered flu vaccinations to carers of vulnerable patients.

• 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.