Archived: Ilkeston Health Centre

Updated 21 April 2016

Dr Purnell and Partners provides primary medical services to approximately 3770 patients through a general medical services contract (GMS). The practice is located in the town of Ilkeston within the borough of Erewash. The town is close to both Nottingham and Derby.

The level of deprivation within the practice population similar to the national average. However, income deprivation affecting children and older people is marginally below the national average.

The clinical team comprises two GPs (one male and one female), two practice nurses and two healthcare assistants/phlebotomists.

The clinical team is supported by a full time practice manager, a reception supervisor and five additional reception and administrative staff.

The practice opens from 8am to 6.30pm Monday to Friday. General booked appointments are offered each morning from 9am to 10.30am. Afternoon appointments are offered from 2pm to 5.30pm on a Monday and from 3pm to 6pm on Tuesdays, Thursdays and Fridays. The practice offers emergency appointments and pre-bookable clinic appointments on Wednesday afternoons. Ten minute emergency appointments are offered each day after morning surgery for patients who need to be seen on the same day. The practice does not provide extended hours surgeries.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United (DHU).

Updated 21 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Purnell and partners on 11 February 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 effective systems in place to report and record significant events which enabled learning to be shared.
• Risks to patients were assessed and well managed through ongoing monitoring. There was a robust programme of infection control audit in place which was facilitated by the infection control lead nurse.
• 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. Where a need was identified, further training was provided.
• Feedback from patients about their care was consistently and strongly positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients praised the kind, caring and compassionate nature of staff and said they were always treated as individuals.
• Staff said they saw their roles as more than a job and explained that two members of staff had given up their time off to take a patient on a day trip to the coast last year following the death of their spouse.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. We observed staff working to ensure the needs of patients were met on the day in spite of no available appointments on the system.
• 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.

We saw several areas of outstanding practice:

• The practice sought to treat patients holistically and offered additional services internally where possible including access to a practice chaplain and support from the Citizens Advice Bureau. There was an emphasis on treating the health needs of patients whilst also giving consideration to social needs, by assisting patients with completing forms for example. Staff consistently went over and above to meet the needs of their patients; including going out of their way to make the lives of patients easier. For example, staff routinely escorted patients who required assistance to the nearest bus stop.
• Staff advocated for the needs of their patients within the practice and externally. For example, a member of staff contacted the local hospital to ensure support was in place for a patient who required a wheelchair.
• Data from the GP patient survey and feedback received as part of the inspection demonstrated that patients felt they received a level of care which exceeded their expectations. For example, a number of comments cards described staff within the practice as exceptional.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 April 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. Care plans were in place for the patients identified as being at risk of admission.
• Performance for diabetes related indicators was 96% which was above the CCG average of 90.2% and the national average of 89.2%.
• The percentage of patients with hypertension having regular blood pressure tests was 89.2% which was above the CCG average of 85.6% and the national average of 83.6%.
• 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 people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 21 April 2016

The practice is rated as good for the care of families, children and young people.

• 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.
• 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 and health visitors.

Updated 21 April 2016

The practice is rated as good for the care of older people.

• The practice offered proactive and personalised care to meet the needs of older people. They worked with the multidisciplinary team to identify frail and vulnerable patients, and those at high risk of hospital admission, to plan and develop individual care packages.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those who needed them. Longer appointments could be booked if these were required.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure were in line with or above local and national averages.

Updated 21 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. This included access to telephone consultations and same day urgent appointments.
• The practice was proactive in offering online services and GP appointments were offered through the online booking system.
• Health promotion and screening was provided that reflected the needs for this age group. For example the practice offered smoking cessation services and encouraged patients to attend for national cancer screening programmes.
• The practice’s uptake for the cervical screening programme was 84%, which was comparable to the CCG average of 83.2% and the national average of 81.8%.

Updated 21 April 2016

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

• 93.3% of patients with a mental health condition had a documented care plan in their records in the previous 12 months which was above the CCG average of 91.6% and the national average of 88.3%. The practice’s exception reporting rate for this indicator was 6.3% which was below the CCG average of 17.5% and the national average of 12.6%.
• Data showed 90.6% of patients with dementia had received a face to face review in the last 12 months which was above the CCG average of 85.3% and the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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.
• 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.

Updated 21 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 those with a learning disability. The practice records indicated they had 24 patients on the learning disability register and 20 of these had received an annual review at the time of the inspection.
• They 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. 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.
• The practice offered additional services to patients whose circumstances may make them vulnerable such as access to the Citizens’ Advice Bureau and a practice chaplain.