Blackwell Medical Centre

Updated 24 March 2016

Blackwell surgery provides primary medical services to approximately 2488 patients through a personal medical services (PMS) contract. Services are provided to patients from a single site which occupies purpose built premises. The practice is part of a larger group of two other practices which work together to support patients.

The level of deprivation within the practice population is similar to the national average. Income deprivation affecting children and older people is below the national average.

The clinical team comprises two GP partners (1 female and 1 male) a salaried GP, an advanced nurse practitioner (ANP), two nurses and a healthcare assistant. The clinical team is supported by a practice manager partner, a practice manager and a team of four administrative and reception staff.

The practice is open from 8am to 6.30pm on Monday to Friday. The consultation times for morning GP appointments vary day to day and start from 8am. Afternoon appointments are offered until 6.30pm. The practice offers extended hours on a Saturday from 9am to 1pm and a Sunday form 12pm to 4pm.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United through the 111 system.

Updated 24 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Blackwell Medical Centre on 14 January 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.
• 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.
• The practice proactively sought to educate their patients to manage their medical conditions and improve their wellbeing, assisted by having additional in house services available on a regular basis, some of which were funded and supported by the practice. These included visiting physiotherapist, citizen’s advice worker, counsellor and well-being worker.
• Information about services and how to complain was available. The practice sought patient’s views about improvements that could be made to the service directly and through an active patient participation group.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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 areas of outstanding practice:

• The practice sought to improve the care provided to patients with long term conditions, such as heart conditions and asthma by providing responsive care in a timely and convenient manner and sought avenues to improve this by involving other care providers such as pharmacies.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 March 2016

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

• The practice had put in place dedicated clinics for the support of patients with long term conditions such as diabetes and asthma, and operated a recall system to ensure patients were receiving appropriate care. This was evidenced in the higher than average results for the care of patients with long-term conditions. For example:

  • The percentage of patients with COPD who had a review undertaken including an assessment of breathlessness in the preceding 12 months was 98% compared to a national average of 90%

• GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Care plans were in place for the patients identified as being at risk of admission.

• The practice monitored patients on warfarin (a medicine which reduces the risk of clots forming) in house. A healthcare assistant or nurse would visit patients at home if required, so bloods could be taken and results monitored to ensure correct doses were prescribed.

• Longer appointments and home visits were available when needed.

• The practice had engaged with the local pharmacy and identified patients with asthma whose condition was well controlled, who would benefit from a pharmacist conducting their annual review.  Once completed this was documented and passed to the surgery to be updated on the patients’ record by the nominated GP.  The practice had audited this which showed there had been 37.5 hours (150 appointments) of clinical time freed which had been reassigned to other patients, including more patients with asthma whose condition was poorly controlled, who required additional care.

Updated 24 March 2016

The practice is rated as good for the care of families, children and young people.

• 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.

• The practice could refer patients to another practice in the group where a family planning consultant ran a clinic and also attend local schools. The group had initiated this scheme following data showing a high number of teenage pregnancies in the area and analysis showed a reduction in the number of teenage pregnancies over the five years the clinic has run.

• One morning a week the practice hosted a well-being clinic which gives patients’ advice and support and signposts patients to appropriate services to best suit their needs.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Urgent appointments were always available on the day.

• The practice offered cervical cytology testing and took this opportunity to consult patients regarding their sexual health and contraception.  Patients who did not attend were followed up to ensure they were given every opportunity to attend the clinic.

Updated 24 March 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of older people in its population.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• They worked effectively with multi-disciplinary teams to identify patients at risk of admission to hospital and to ensure their needs were met. The percentage of people aged 65 or over who received a seasonal flu vaccination was 77% which was in line with the national average of 73%.

• The practice had patients living in two local care homes which a designated GP visited each week undertaking urgent and routine appointments and health checks. We spoke with staff at a care home who said the care the practice provided was crucial to patients being able to receive support and care in the community.

Updated 24 March 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. This included access to telephone appointments, and the availability of weekend appointments.

• The practice offered online services such as electronic prescriptions, and GP appointments were offered through the online booking system.

• Health promotion and screening was provided that reflected the needs for this age group.

• Patients were offered a choice when being referred to other services to take into account the most convenient location for travel.  This was particularly important for patients of this practice as it lay between Nottinghamshire and Derbyshire Trusts.

Updated 24 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people 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 where they may have been experiencing poor mental health.

• The practice provides rooms for in-house counselling for patients who had been referred or self-referred to the service.

• Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 24 March 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The healthcare assistant had six hours a week allocated to act as a care co-ordinator. In this role they monitored the attendance and discharge of patients from secondary care. Initial phone calls were made and follow up appointments, including home visits if required, were booked and services from the practice and the community team made available to support patients’ rehabilitation.

• The practice offered longer appointments for people with a learning disability.

• The practice hosted a citizens advice walk- in clinic one morning a week to support local people and give advice on what support was available to them. This reduced the necessity to travel to the local town and was a well-known resource within the community.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice had a GP with a special interest in the Mental Capacity Act, best interest and Gillick and Fraser guidance (guidelines which help balance child rights and wishes with the responsibility to keep children safe from harm) and was available to staff to for support and guidance in this area.

• 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.