Mansfield Medical Centre

Updated 8 September 2016

Mansfield Medical Centre is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 9,800 patients living in the Binley and surrounding areas of Coventry. A GMS contract is a standard nationally agreed contract used for general medical services providers. The practice provide a range of additional and enhanced services including minor surgery.

The practice operates from a two storey building and patients are seen on the ground floor only. Administration staff and the practice manager operate from the first floor. The practice population has a higher than average number of patients aged 25 to 55 years and those over 85 years. National data indicates that the area is one that experiences moderate levels of deprivation. The practice population is made up of predominantly white British patients and a significant number of patients from Eastern Europe and approximately 20% of patients of patients from Asian and Black ethnic origin.

There are three GP partners, two of whom are female, and one male. They employ three salaried GPs, two male and one female. The practice employs three practice nurses, one health care assistant, a practice manager and assistant practice manager, who are supported by a team of administrative and reception staff.

The practice is premises is open on Monday until Friday between 8.30am and 6.30pm, and offers extended hours appointments from 6.30pm until 7pm on Monday to Thursday and on Saturdays from 8am until 11am for pre-bookable appointments only. The practice closes for lunch from 1pm until 1.30pm on Monday, Tuesday, Thursday and Friday and from 1pm until 2pm on Wednesdays. The telephone lines are open from 8am through until 6.30pm and the GPs can be accessed during this time. When the surgery is closed services are provided by Virgincare who can be contacted via NHS 111.

Updated 8 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mansfield Medical Centre on 12 July 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 an effective system in place for reporting and recording significant events. We noted these were well documented and that thorough investigation took place.
• Risks to patients were assessed and well managed and these were well documented.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Patients spoke highly of all the staff at the practice during our inspection, via the comment cards and in the patient survey. We saw evidence of acts of compassion and caring.
• Information about services and how to complain was available and easy to understand and complaints were handled in a timely manner. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment and there was continuity of care, with urgent appointments available the same day. The practice had an innovative colour coded system of appointment allocation.
• 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 and staff spoke positively regarding the support and leadership from management and the partners.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Consider introducing a system to notify the GP if prescriptions are not collected.
• Ensure verbal complaints are recorded.

• Ensure a robust system is in place to check fridge temperatures in the absence of regular staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 8 September 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 and patients at risk of hospital admission were identified as a priority. For example, nurses had additional training in diabetes and respiratory conditions.
• The practice had maximum achievement in the overall diabetes domain within the Quality and Outcomes Framework (QOF), which was above the CCG and national averages of 89%. They also had above average achievement in all individual diabetes indicators and below average exception reporting.
• One practice nurse had a special interest in diabetes and had carried out audits, presented findings to the GPs and implemented changes in the practice which contributed to the practice high achievement in diabetes.
• Longer appointments and home visits were available when needed. For example, we saw double appointments and 30 minute appointment for patients with multiple chronic conditions to prevent the need for several attendances.
• The practice hosted the retinal screening at the practice for patients with diabetes which prevented the need to travel to hospital.
• The practice was working with the patient participation group to develop an ‘expert patient’ programme to be patient-led to educate newly diagnosed patients with diabetes and help them learn to live with their condition and share experiences.
• 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 8 September 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. Immunisation rates were 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 were specifically allocated for this group of patients. The premises were suitable for children and babies. Children were always seen on the same day as a priority.
• We saw positive examples of joint working with the health visitor and the midwife attended the practice twice a week.
• The practice offered chlamydia screening to patients aged 15- 24 years.
• They had registered to offer the ‘C-Card’ facility which allowed young people to attend the practice to collect barrier methods of contraception without the need to explain what they had attended for.

Updated 8 September 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. They had implemented a ‘purple patient’ system which allowed patients with complex conditions who may have urgent medical needs the facility to contact the practice via an allocated number and had a system to alert staff to these appointments.

• The practice worked with the PPG and other members of the community to develop and introduce schemes to help older patients such as the ‘Let’s Get Moving’ programme in and patient-led education sessions about how to live with diabetes which was work in progress.

• Over 75 health checks were offered opportunistically.
• The practice had access to the integrated neighbourhood team (INT) which was a multi-disciplinary team, included a care co-ordinator and involved access to a variety of support agencies such as Age UK.

Updated 8 September 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 offered extended hours appointments on four evenings of the week and on Saturday mornings for those patients who could not attend during core hours. This included availability of appointments with the nurse during these extended hours
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group, for example, smoking cessation and weight management. Cervical screening uptake rate was 79% which was comparable with the national average of 82%.

Updated 8 September 2016

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

• Overall achievement in mental health outcomes were comparable with the national averages. Seventy-eight percent of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 84%.
• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had had a comprehensive, agreed care plan documented in their record, in the preceding 12 months which was comparable to the national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice 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 and had three counsellors who attended the practice to offer psychological and emotional support to these patients.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 8 September 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 and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability and other patients with complex needs.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients and could refer to support agencies such as Admiral nurses and AgeUK for patients who were carers. The practice had a significant amount of information regarding carers in the waiting area. We noted information regarding access to carer support in the immediate entrance, which was available in different languages.
• The practice informed 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.