Stirling Medical Centre

Updated 19 May 2022

Stirling Medical Centre is located in Grimsby at:

Stirling Medical Centre

Stirling Street

Grimsby

DN31 3AE

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury.

The practice is situated within the North East Lincolnshire Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) to a patient population of about 3,323. This is part of a contract held with NHS England. The building is shared with two other GP practices.

The practice is part of a wider network of GP practices. The group of 13 practices is known as Panacea Primary Care Network (PCN) and serves 47,000 patients. They work together to provide access to additional services such as a pharmacist, First Contact Physiotherapist and dietician. The practice manager is also the joint manager of the primary care network.

Information published by Public Health England shows that deprivation within the practice population group is in the lowest decile (one of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 1.2% Asian, 97.4% White, 0% Black, 0.8% Mixed, and 0.3% Other.

The age distribution of the practice population closely mirrors the local and national averages.

There is a team of one GP supported by a locum GP. The practice has one locum nurse who provides nurse led clinics for long-term conditions and a health care assistant. The GPs are supported at the practice by a team of reception/administration staff. The practice manager provides managerial oversight.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is offered an appointment.

Extended access is provided locally by the PCN, where late evening and weekend appointments are available. Out of hours services are accessed by calling 111.

Updated 19 May 2022

We carried out an announced inspection at Stirling Medical Centre on 21 and 22 March 2022. Overall, the practice is rated as Requires Improvement.

We rated each key question as follows:

Safe - Requires Improvement

Effective - Requires Improvement

Caring - Good

Responsive - Good

Well-led - Requires Improvement

Why we carried out this inspection.

This inspection was a comprehensive inspection. It was the first inspection since registration of the service as an individual GP in 2020 after the previous partnership was dissolved.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• A short site visit

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Requires Improvement overall.

We found that:

• The practice had not always provided care in a way that kept patients safe and protected them from avoidable harm. This was because recruitment polices were not always fully implemented and there were gaps in some management of medicine systems.
• The majority of patients received effective care and treatment that met their needs. However, not all patients had had their long-term conditions reviewed in a timely manner and some patients prescribed high risk medicines were not being adequately monitored.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way, and this had been maintained throughout the pandemic.
• Data showed good levels of patient satisfaction with the service and no complaints had been received by either the practice or CQC.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. However, there were some areas relating to recruitment, oversight of training, staff appraisal and safe management of medicines which had had not been well managed and associated risk had not always been assessed and minimised.

We found three breaches of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties

The provider should:

• Review systems relating to monitoring indemnity insurance for locum staff.
• Assure themselves work to the buildings electrical system has been completed.
• Review and improve the practice website to make information about support groups available.
• Share the practice vision and strategy and information about the freedom to speak up guardian with staff.
• Involve patients in the running of the practice through a patient participation group.
• Review systems to enable smart cards so staff have access to all the areas they require for their role.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care