Gleadless Medical Centre

Updated 11 August 2016

Gleadless Medical Centre is located in a purpose built health centre in Gleadless Valley and accepts patients from the surrounding area. Public Health England data shows the practice population has a higher than average number of 0 to 30 year olds compared to the England average. The majority of the patients registered with the practice are white British and the practice catchment area has been identified as one of the first most deprived areas nationally.

The practice provides Primary Medical Services (PMS) under a contract with NHS England for 8708 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as anticoagulation monitoring and childhood vaccination and immunisations.

Gleadless Medical Centre has five GP partners (one female, four male), two female salaried GPs, four practice nurses, two healthcare assistants, business manager and an experienced team of reception and administration staff. The practice is a teaching practice for medical students.

The practice is open 8.15am to 6pm Monday to Friday with the phones operating between 8am and 6.30pm. Consultations are available between 8.30am and 6pm Monday to Friday. Extended hours appointments are offered 6.30pm to 7pm Wednesday evenings. When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service who would offer advice or refer to the Sheffield GP Collaborative if appropriate. Patients are informed of this when they telephone the practice number.

Updated 11 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gleadless Medical Centre on 21 June 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.
• Risks to patients were assessed and well managed with the exception of the frequency of basic life support training and the recording of the immunity status of clinical staff.
• 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.
• Information about services and how to complain was available and easy to understand. The practice actively reviewed complaints and improvements were made to the quality of care as a result of complaints, concerns and patient feedback.
• Patients said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day through the GP telephone consultation 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.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

• The clinical staff produced a specific individual care plan for patients who had long term conditions, for example, diabetes at the end of the consultation or annual review. This included clinical information such as cholesterol, blood pressure and blood glucose levels. It calculated the patient’s risk of cardiovascular disease and explained what this meant to them personally. It included medication information and an action plan of ways to control their condition. There was space at the back of the form for patients to write down things they wanted to discuss at their next appointment. Staff told us this gave the patient time to reflect on the results and the agreed treatment plan and encouraged patients to be more proactive in managing their condition.

The areas where the provider should make improvements are:

• Complete carpet and curtain cleaning every six months as specified in NHS National Patient Safety Agency specification guidance for cleanliness in primary care premises.

• Complete basic life support training more frequently for both clinical and non clinical staff as specified in the resuscitation council (UK) guidelines for staff working in primary care.

• Maintain a complete record of the immunity status of clinical staff as specified in the practice’s own Occupational Health policy and in the national Green Book (immunisations against infectious disease) guidance for healthcare staff.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 11 August 2016

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

• Nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.

• 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 patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The clinical staff produced a specific individual care plan for patients who had long term conditions, for example, diabetes at the end of the consultation or annual review.

Updated 11 August 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 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.

• QOF data showed 90% of women eligible for a cervical screening test had received one in the previous five years compared to the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors.

Updated 11 August 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.

• The practice provided medical care and weekly routine GP visits to patients who resided in two local care homes.

• The percentage of patients aged 65 or over who received a seasonal flu vaccination was 81%, higher than the national average of 73%.

Updated 11 August 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 evening appointments on a Wednesday at the practice and weekend and evening appointments at a local practice through the Sheffield satellite clinical scheme.

• The practice offered appointments with an occupational health adviser and was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 11 August 2016

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

• Of those patients diagnosed with a mental health condition, 85% had a comprehensive care plan reviewed in the last 12 months, which is comparable to the national average of 88%.

• Of those patients diagnosed with dementia, 76% had received a face to face review of their care in the last 12 months, which is lower than the national average of 84%.

• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living 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.

• The practice 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 patients with mental health needs and dementia.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT), a counselling service to support patients’ needs.

Updated 11 August 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 offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had developed a virtual ward round.This was a real time log of patients who were in hospital or who had recently been discharged. The practice was then able to monitor their follow up care. For example, we observed a patient discharged the day before had been contacted by the practice and an appointment made to review their respiratory condition and care plan. The GPs met weekly with the district nurses to discuss these patients. The practice also used this information to identify patients who had multiple in-patient stays who may be vulnerable or require extra support. The practice had identified five such patients in the past 12 months who were then included on the unplanned admissions register to be monitored more frequently.

• The practice hosted a community support worker who would advise and signpost patients to services. For example, information on housing and social care or support to join local social activities.

• 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.