Dr Hakes & Partners

Updated 22 April 2016

Dr Milner and Partners is a two site practice situated in West Sheffield. Both practices are situated in modern and purpose built premises with on site parking and good transport links into the city centre. The practice patient list size is 10,417.

The clinical team consists of two GP partners (both male), five salaried GPs (all female), two practice nurses (both female), one nurse prescriber (female) and two health care assistants (both female). Dr Milner and Partners is a teaching practice and takes medical students. The management and administration team consists of a business manager, practice administrator, three medical secretaries, two administrative assistants, two senior receptionists and nine receptionists.

The practice is open between 8 and 6  Monday to Friday. Appointments are from Appointments are from 8.30 to 11.50 and 3.30 to 5.35. Extended surgery hours are offered on Tuesday evenings 6.30 to 8 and every Saturday 8.15 to 11. NHS 111 services are in place if the practice is closed.

Regulated activities (diagnostic and screening procedures, family planning, surgical procedures, treatment of disease, disorder or injury, maternity and midwifery services) are provided from Tramways Medical Centre (main site) and Middlewood Medical Centre (branch site).  Both locations were inspected.

Updated 22 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 17 March 2016 at Dr Milner and Partners. 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 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.
• Not all patients said they found it easy to make an appointment with a named GP, however there was continuity of care, with urgent appointments available the same day.
• The practice had very 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 offered open access to appointments for all patients under 16 years.

The areas where the provider should make improvements are:

• Ensure that all staff training is up to date.
• Paediatric defibrillator pads should be obtained.
• Completed actions from the Infection Prevention and Control (IPC) audit should be dated.
• The practice complaints response letter should include the Parliamentary Health Service Ombudsman contact details.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 22 April 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 management and patients at risk of hospital admission were identified as a priority.
• The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 91% and higher than the national average of 88%.
• 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 22 April 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 &Emergency attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• The percentage of patients diagnosed with asthma, on the register, who had an asthma review in the the last 12 months that includes an assessment of asthma control was 80% and higher than the national average of 75%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The percentage of women aged 26-64 whose notes record that a cervical screening test has been performed in the preciding 5 years was 96% and higher than 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 22 April 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 22 April 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 22 April 2016

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

• 93% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is higher than the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months is 95% and higher than the national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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 those living with dementia.

Updated 22 April 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 multi-disciplinary teams in the case management of those whose circumstances may make them vulnerable.
• The practice informed vulnerable patients about 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.