Pinfold Medical Practice

Updated 19 November 2015

Pinfold Medical Practice is a GP practice in the town of Loughborough in Leicestershire. It provides a range of primary medical services to approximately 10,700 patients. The services are provided by seven GP partners, one salaried GP and one long-term locum GP, three practice nurses (including a nurse practitioner) and three healthcare support workers. They are supported by a management team and reception and administration staff. The practice provides 48 GP sessions each week. There are four male GPs and five female GPs. The practice is a training practice. It has registrars who are fully qualified doctors who are training to work in general practice and also medical students who spend some time learning about general practice.

The practice is supported by local community health teams which provide maternity and health visitor services.

The practice occupies part of Loughborough Medical Centre, which is a single-storey building with parking available including designated disabled bays. There are automatic doors and a wheelchair available for patient use.

The practice holds a General Medical Services (GMS) contract to deliver essential primary care services. It works within West Leicestershire Clinical Commissioning Group (CCG). A CCG is an NHS organisation that brings together GPs and health professionals to take on commissioning responsibilities for local services. We reviewed information from the CCG and Public Health England which showed that the practice population had deprivation levels similar to the average in England.

The practice is open between 8am and 8pm on Monday and 8am to 6.30pm Tuesday to Friday. (Closed 12.30pm to 1.30pm on Tuesdays.) Appointments are available between 8.10am and 5.30pm. (7.45 on Mondays). The practice has opted out of providing an out of hours service when the surgery is closed. This is provided by the Leicester, Leicestershire and Rutland out of hours service which covers the area and can be accessed through the NHS 111 number.

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Pinfold Medical Practice on 20 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, and people experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Urgent appointments and telephone consultations were available on the same day but not necessarily with patients having a choice of GP.
• The practice made good use of audits to improve patient care.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

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 were supported by nurse specialists who visit the practice regularly. There were GP leads for diabetes, asthma, COPD, mental health, CKD and cardio vascular diseases. The practice provided a full anticoagulation service and improving the quality of that was a main focus.

The practice had developed a system it called integrated recall which was a streamlined approach to identifying patients who needed annual checks, organising these in a timely and effective way and ensuring all the results were available when the patient had their annual review with the GP.

The practice kept a register of patients with more complex needs including those requiring end of life care. The named GP worked with other health and care professionals to ensure care and support was provided. Relevant information was made available to out of hours providers for those patients receiving end of life care to ensure appropriate treatment and support.

Updated 19 November 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify looked after children and children at risk. The practice monitored children and young people who had a high number of A&E attendances and Out of Hours service use. The practice offered postnatal and six-week baby checks and a full in-house immunisation and vaccination service. The practice had an emergency care nurse and duty doctor and was able to provide on the day appointments which was particularly well used by parents with sick children.

Updated 19 November 2015

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. It had developed a proactive care template which it used to ensure patients’ needs were assessed and treated appropriately. This included people requiring end of life care. Patients with complex needs were discussed with members of the multidisciplinary teams to ensure appropriate care and support was provided. It had a register of patients who were house bound. Their care was reviewed at least annually and a GP made regular visits to them. The practice provided care and support to the residents of two care homes with two visits each week to each home. The GP took summary care records with them to ensure continuity of care. Patients were offered flu and shingles vaccinations with an active recall system if patients missed them.

Updated 19 November 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). Appointments and repeat prescriptions could be arranged online. The first appointment each day was 8.10am and the practice was open till 8pm on Monday evenings. Daily telephone consultations were available to help provide minimal disruption to working people. A full contraceptive service including on the day evening appointments with a specialist nurse was provided.

Flu vaccination clinics were provided on a Saturday to enable working people to attend or to bring an elderly friend or relative without disruption. A fully trained travel nurse was available to advise patients about travel vaccinations.

Updated 19 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had a register of people with mental illness which was reviewed annually and patients were offered an annual physical health check with a nurse which their GP would encourage them to attend. The practice undertook dementia screening and offered check-ups to carers. It worked closely with pharmacists to ensure that patients with memory impairment had their medication prescribed safely using dossett boxes where appropriate.

There was an in-house mental health practitioner who provided counselling and the practice also worked closely with secondary care mental health services including the CRISIS team and community psychiatric nurses. The practice provided information to patients experiencing poor mental health about support groups and voluntary organisations. This was also on the practice website.

Staff had received training on how to care for people with mental health needs and dementia.

Updated 19 November 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice had identified those of its patients who had a learning disability. These patients were offered annual health check and longer appointments. The practice was working closely with the CCG on a scheme for homeless people. People could use the practice without having a permanent address and were offered help and care with mental and physical health, vaccinations and where appropriate, substance misuse. It had also developed a good working relationship with a local project providing support for homeless people.

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 and outside normal working hours.