Millfield Surgery

Updated 17 September 2015

Millfield surgery is located in the town of Easingwold . There are 7,120 patients on the practice list and the majority of patients are of white British background. The practice manager told us there were a higher proportion of older patients on the practice list compared with other practices in the area.

The practice dispenses medications to their patients who live one mile from the local pharmacy. The practice is a training practice, there are four GP Partners (2 male and 2 female) there is one female GP associate. There is a Practice Manager and one Advanced Nurse Practitioner, two practice nurses, a healthcare assistant and one phlebotomist. There is a dispensing manager and two dispensers. In addition there are a range of administrative personnel to support everyday activities. The practice is open 8am to 6.00pm on Monday- Friday. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service provided by Northern Doctors.

The practice has a General Medical Service (GMS) contract and also offers enhanced services for example: minor surgery, a Patient Participant Group (PPG), and patients with Learning Disabilities have their physical health pro-actively managed.

Updated 17 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Millfield Surgery on 4 August 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• 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.
• 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 two areas of outstanding practice:

• The practice engaged with Easingwold Town Council, voluntary organisations as well as, health care commissioners and social services departments to help ensure that changes to the locality were discussed; so that health and social care provision would meet the needs of the ever growing local population.
• The practice ran a monthly multidisciplinary team meeting for any patient registered at the practice who required additional health and social care support. Voluntary organisations were invited, where appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 September 2015

The practice is rated as good for the care of patients 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. Longer appointments and home visits were available when needed. All of these patients had a named GP and a structured annual review to check that their health and medication 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. Monthly pro-active care review meetings were held.

Updated 17 September 2015

The practice is rated as good for the care of families, children and young patients. 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 patients 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 the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and social workers.

Updated 17 September 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, in dementia and end of life care. They were responsive to the needs of older patients, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 17 September 2015

The practice is rated as good for the care of working-age patients (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 they offered to ensure these were accessible, flexible and offered continuity of care. 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.

Updated 17 September 2015

The practice is rated as good for the care of patients experiencing poor mental health (including those with dementia). 90% of patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. They carried out advance care planning for patients with dementia.

Patients experiencing poor mental health had been told 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 (A&E) when they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 17 September 2015

The practice is rated as good for the care of patients whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances and those with a learning disability. They had carried out annual health checks for patients with a learning disability and all of these patients had received a follow-up. Longer appointments for patients with a learning disability were available.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. They had told vulnerable patients 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.