Archived: Your Health partnership - Mace Street Clinic

Updated 25 February 2016

Your Health Partnership is registered with the Care Quality Commission at six locations. However, two of the locations; Whiteheath Medical Centre (Badsey Road) and Mace St Clinic (Mace St) have one General Medical Services (GMS) contract, patient list and clinical data system with a shared staff group. The staff group, policies, systems and procedures for both sites are generally managed from Whiteheath with input centrally from the corporate partnership (Your Health Partnership). The policies and systems are reflective across both registered practices and therefore we inspected both sites together on 5 January 2015. The data included in this report also reflect both practices.

The corporate partnership has 16 GP partners. However, two of the partners (1 male and 1 female) were based at Whiteheath Medical Centre (Badsey Road) and Mace St Clinic (Mace St). There are also three salaried GP (2 female and 1 male) who also worked at the practice. There are also two practice nurses and a Healthcare Assistant (HCA). Advanced Nurse Practitioners (ANP) who were employed by the corporate partnership also held specialist clinics at both sites but were not based at the sites at Whiteheath or Mace St. There was an Outlet Operations Manager who was based at the practice along with a team of receptionists and other administration team members. The Operations Outlet Manager also worked at the branch site at Mace St Clinic. A care co-ordinator was also based at the practice once a week but was employed by the Clinical Commissioning Group (CCG). Their role is to identify patients at risk of unplanned admission to hospital. CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

The practice is open between 8.30am and 1pm Mondays to Fridays in the mornings. In the afternoon the surgery is open from 3.30pm to 6pm except Thursdays when is open from 2pm to 5pm. Appointments are from 9am to 12pm every morning and 4pm to 6pm daily except Thursdays when it is closed in the afternoon. Extended opening hours are Mondays from 6.30pm to 7.30pm with a nurse and Tuesdays from 6.30pm to 7.30pm with a GP.

The practice does not provide an out-of-hours service but has alternative arrangements in place for patients to be seen when the practice is closed.

The practice provides minor surgical procedures mainly in cryotherapy and joint injections.

The practice has a patient participation group (PPG) who are a group of patients registered with a practice that work with the practice team to improve services and the quality of care.

The practice has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice building is purpose built and is accessible by patients using a wheelchair.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Your Health Partnership - Whiteheath Medical Centre on 5 January 2016. Overall the practice is rated as good.

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

• There was 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. The practice website informed patients of the complaints process and the services available. It could be translated in various languages.
• Patients said that access to appointments had improved and the service was improving.
• The practice building was purpose built and had good facilities, 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.

The areas where the provider should make improvement are:

• Ensure readings are re-set after each recording to ensure that maximum and minimum temperatures being recorded were accurate for each recording.

• Ensure all staff attend training updates for courses such as cervical cytology and mental capacity.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 February 2016

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management. There was a care co-ordinator based at the practice one day a week. They were employed by the CCG and their role was to identify patients at risk of hospital admission. GPs were notified of these patients and care plans were developed with them. The practice was part of a corporate partnership and nurses delivered specialised clinics in diabetes and dementia across the site. 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 25 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 met regularly with multi-disciplinary teams to discuss children who were on a child protection plan or those who were at risk. All practice staff had access to contact details for the local safeguarding team. Antenatal and post-natal clinics were available along with childhood and adolescent vaccination programmes. Same day appointments were available for children and appointments were available outside of school hours and the premises were suitable for children and babies. Saturday flu clincs were offered at the main site at Whiteheath Medical Centre to enable improved access and uptake of the flu vaccine. We saw parents with pushchairs were able to access the practice and there was adequate space in the reception area. The lead GP was safeguarding lead for the practice and the corporate practice. We saw that they had attended training up to level 2 and were booked to attend level 3 training in February 2016. We spoke with the lead GP who had displayed adequate safeguarding knowledge to protect vulnerable adults and children.

Updated 25 February 2016

The practice is rated as good for the care of older people. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice worked in partnership with multi-disciplinary teams to discuss each patient’s situation and agree next step planning. Patient’s expectations, values and choices were taken into consideration when planning care.

Updated 25 February 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice had adjusted the services to offer flexible appointments out of hours. Patients were encouraged to register for text message reminders for appointments as well as telephone appointments to enable those staff with work commitments access to services. Along with telephone triage, a full range of health promotion and screening service such as cervical cytology screening was available and reflected the needs of this age group.

Updated 25 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had a dementia register and a mental health register. Patients experiencing poor mental health in these groups received annual physical health checks from a specialist nurse or a GP. The practice carried out advance care planning for patients with dementia. 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 (A&E) where they may have been experiencing poor mental health.

Updated 25 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 learning disabilities, dementia and mental health. The practice offered longer appointments for patients with a learning disability. Regular reviews of the practice register were undertaken to monitor for any changes in patient circumstances. Regular screening of patients such as those with dementia was undertaken by a specialist nurse. Staff knew how to recognise signs of abuse in vulnerable adults and children. The practice informed vulnerable patients about how to access various support groups and voluntary organisations. 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 regularly worked with multi-disciplinary teams in the case management of vulnerable people.