Fountain Medical Centre

Updated 11 February 2016

Fountain Medical Centre is located in Newark-on-Trent, a market town in Nottinghamshire. The town stands on the River Trent, the A1 and is served by the East Coast Main Line railway.

Services are provided from purpose built premises located in the town centre. The current premises have been occupied by the practice since 1986. The practice has facilities for disabled patients, baby changing facilities and limited car parking.

The practice provides primary medical services to 14109 patients under a General Medical Services (GMS) contract. The level of deprivation affecting the practice population is slightly below the national average. Income deprivation affecting children and older people is also slightly below the national average.

The clinical team comprises five GP partners, one salaried GP, a nurse practitioner, four practice nurses and two health care assistants. The clinical team is supported by a full time practice manager, an office manager and a range of reception and administrative staff.

The practice is open from 8am to 6.30pm Monday to Friday with the reception open from 8.15am. The practice closes each Friday between 12.45pm and 2pm for clinical meetings (though the telephone lines remain open and staffed). Consultation times are from 8.15am to 6.30pm although the website states that these surgery hours may vary. Extended hours surgeries are offered on Monday mornings from 6.30am to 8am and on Saturday mornings from 8am to 12pm for pre-booked appointments.

The practice has opted out of providing out-of-hours services to its patients. This service is provided by Central Nottinghamshire Clinical Services (CNCS).

Updated 11 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fountain Medical Centre on 11 November 2015. Overall the practice is rated as good.

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

• The practice had arrangements in place to deal with information about safety. Staff were aware of their responsibility to report incidents and concerns and knew how to do this. Information relating to safety was documented, monitored and reviewed.
• Risks to patients and staff were assessed and well managed
• Staff used best practice guidance to assess patients’ needs and plan their care.
• The practice ensured all staff had received relevant role specific training and further training needs were identified for staff through appraisal
• Patients told us that staff treated them with compassion, dignity and respect and involved them in decisions about their care
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was generally 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.
• There were effective systems of governance in place and evidence of strategic planning for the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 February 2016

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

• Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Patients identified as being at risk of admission to hospital were discussed at monthly multidisciplinary meetings.

• Indicators to measure the impact of the management of diabetes were higher than local and national averages. For example, the percentage of patients on the practice register for diabetes with a record of a foot examination and risk classification in the last 12 months was 93.0%. This was marginally above the local and national averages.

• Longer appointments and home visits were available for patients who required these.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 February 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. The practice held regular meetings with attached professionals to discuss children identified as being at risk.

• 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 78% which was comparable to the national average of 74.3%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Urgent appointments were always available on the day.

• We saw good examples of joint working with midwives, health visitors and school nurses.

• Two female GPs provided a service to fit coils and contraceptive implants. In addition a practice nurse was undertaking the family planning course. 

Updated 11 February 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.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice worked effectively with the multi-disciplinary team to identify patients at risk of admission to hospital and to ensure their needs were met. Multidisciplinary meetings were held at the practice on a monthly basis.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was 79.3% which was above the national average of 73.2%. Flu clinics were supported by the practice’s patient participation group (PPG).

Updated 11 February 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. This included access to appointments including telephone consultations.

• The practice was proactive in offering online services and all GP appointments were offered through the online booking system

• Health promotion and screening was provided that reflected the needs for this age group.

• Extended hours consultations were offered on Monday mornings and Saturday mornings to facilitate access for patients in this group.

Updated 11 February 2016

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

• Data showed that 77.4% of patients with a mental health condition had a comprehensive care plan documented in their records in the previous 12 months which was similar to the CCG average.

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

• It 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.

• It 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 people with mental health needs and dementia. All staff and members of the patient participation group (PPG) had undergone training to become ‘Dementia Friends’ and the PPG had worked with the practice to ensure it was dementia friendly.

Updated 11 February 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.

• It offered longer appointments for people with a learning disability in addition to offering other reasonable adjustments.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice told 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. They 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.