Archived: Medicom Limited

Updated 13 January 2017

Medicom Limited is registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 2,100 patients living in the Deepdale area of Preston. The practice is sited in a purpose built premises, together with another larger general practice and a dentists. The practice has one male GP, he is supported by two regular locum GPs (one female and one male), a nurse practitioner, two reception staff and two practice manager, who job share. Medicom Limited holds a General Medical Services (GMS) contract with NHS England.

The practice is open Monday to Friday 8am – 6.30pm and Saturday mornings between 8am and 11am.

Appointments are available 9am to 11.30am and 4pm to 5.30pm on Mondays, Tuesdays and Wednesdays. Also from 9am to 10am on Thursday mornings and 9am to 11.30am and 4pm to 5.30 on Fridays. Weekend appointment are available between 8.10am and 10.20am on Saturdays.

Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice is part of NHS Greater Preston Clinical Commissioning Group (CCG) and is situated in a less affluent area in Deepdale. The practice population is made up of population groups older than the national averages. For example 22% of people are over 65 years compared to a national average of 17%. Fifty three percent of the patient population has a long standing health condition which is lower than the CCG and national averages of 54%. Life expectancy for both males and females is around the CCG and national average of 79 years for males and 83 years for females.

The practice does not provide out of hours services. When the surgery is closed patients are directed to the local GP out of hours service (Go to Doc) via NHS 111. Information regarding out of hours services was displayed on the website on a telephone recorded message.

Updated 13 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Medicom Limited on 7 December 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 significant events. Safety alerts were received and acted upon, however systems for recording and monitoring them were required.
• Risks to patients were assessed and well managed.
• 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.

• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.

• Infection control procedures were in place.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Staff knew most of the patients well and were able to provide a personal service.
• Information about services and how to complain was available and easy to understand.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear approach to working with others to improve care outcomes with a clear strategy and objectives including engaging with other key partners in providing health services.
• There was a clear leadership structure and staff were supported by the GP, however felt uninformed about ongoing changes to the service .
• The provider was aware of and complied with the requirements of the duty of candour.

There were areas of practice where the provider should make improvements, these were:

• Have a more comprehensive effective approach to formal meetings in order that issues, actions and results are recorded.

• Ensure there is an effective system for recording and monitoring safety alerts.

• Ensure training is planned and recorded in a more structured and effective manner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 January 2017

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

• Nursing staff and the GP had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Data from the 2015/2016 QOF performance showed the practice achieved 97% of the total points available for all performance indicators. This was above the CCG and National average. For example: indicators for Osteoporosis was 100% and above the national average of 87% .

• Longer appointments and home visits were available when needed for patients with long term conditions and multiple conditions. All these patients were monitored and had a structured annual review to check their health and medicines needs were being met.

• Medical records for vulnerable patients with long term conditions were highlighted so that all staff knew their needs and arranged appointments and care accordingly.

Updated 13 January 2017

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 good for all standard childhood immunisations with immunisations uptake for all children aged five and under.

• 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.

• Unwell children were always offered same day/urgent appointments.

• Cervical screening indicators were 100% which was above the CCG and national averages of 95% and 97%.

• Appointments were available outside of school hours and could be managed online.

Updated 13 January 2017

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

• The practice had an elderly population which was above the national and local clinical commissioning group (CCG) average. Elderly patients (over 65) represented 22% of the patient list which was above national average of 17%. 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 people in its population and had a range of enhanced services, for example, in avoiding unplanned hospital admissions, dementia, and end of life care.

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

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were good. For example the percentage of patients with atrial fibrillation treated with anticoagulation or anti platelet therapy was 100% and higher than the CCG and national average.

• All the older patients had a named GP who coordinated their care and contacted patients over 75 following discharge from an unplanned hospital admission.

Updated 13 January 2017

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 online bookings of appointments and prescription requests and telephone consultations. Appointments could be pre booked or booked on the day and emergency appointments were also available daily for those in need and children.

• The practice offered a full range of health promotion and screening that reflected the needs for this age group for example NHS health checks for those aged 40 to 75 years old.

Updated 13 January 2017

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

• 82% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable the national average of 84% and CCG average of 86%.

• 100% of patients above the national average of 85% and CCG average of 84%.

• 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 could signpost to relevant specialist services.

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

Updated 13 January 2017

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. Alerts on medical records identified when a patient was vulnerable or was living in vulnerable circumstances.

• The practice had two patients with a learning disability registered and offered longer appointments for these. We saw good examples of where care was personalised to the individual needs.

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

• The practice worked with and 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.