Grange Farm Medical Centre

Updated 24 April 2024

Grange Farm Medical Centre is located in Billborough, Nottingham at:

17A Tremayne Road

Billborough

Nottingham

NG8 4HQ

The premises are purpose built for the provision of primary medical services and is accessible to patients with wheelchairs and those with limited mobility.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

The practice is situated within the Nottingham City Integrated Care System (ICS) and delivers General Medical Services Alternative Provider Medical Services (APMS to a patient population of about 5,900. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices Nottingham City General Practice Alliance (NCGPA).

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the first lowest decile (one of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 69.4% White, 14% Asian, 7.7% Black, 5.9% Mixed, and 3% Other.

The age distribution of the practice population has lower averages of people 65 years of age and over, lower averages of Working Age People and higher averages of Young People compared to the local and national averages.

The practice consists of 5 GPs, 2 (ANPs) Advanced Nurse Practitioners and 3 nurses who provide nurse led clinics for long-term condition. The practice has a practice manager who is supported by clerical and administrative staff to support the day to day running of the practice.

The practice is open between 8 am to 6.30 pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

When the practice is closed patients are able to use the NHS 111 out of hours service.

Updated 24 April 2024

We carried out an announced comprehensive inspection at Grange Farm Medical Centre on 12 December 2023. Overall, the practice is rated as requires improvement.

Safe - Requires improvement

Effective - Requires improvement

Caring - Good

Responsive - Good

Well-led - Requires improvement

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities. The focus of inspection included a review of all key questions.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews face to face and by using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm. This included safeguarding systems, safe recruitment, infection prevention and control and the management of the premises and associated risks.
• However, the practice did not adequately supervise non-medical prescribers and clinical pharmacists in a way that kept patients safe and protected them from avoidable harm.
• Our review of clinical records found safe management of medicines, in particular those that required ongoing monitoring due to adverse risks.
• Systems were in place to support the practice to learn and make improvements when incidents and complaints occurred.
• Patients received effective care and treatment that met their needs. Our review of clinical records found appropriate follow up of patients with or at risk of long-term conditions.
• Uptake of childhood immunisations and cervical screening were below the national target and national average.
• Patient feedback from various sources was mixed about the way staff treated and involved them. Results from the GP national patient survey on some questions relating to patient experience were lower than local and national averages.
• The way the practice was led and managed did not promote the delivery of high-quality, person-centre care. Local management and reception staff required additional support to enable them to carry out their roles effectively.
• There was a strong emphasis of working with partners to tackle health inequalities.
• The practice provided a supportive culture with clear direction for the future of the service.

Whilst we found no breaches of regulations, the provider should:

• Implement a system to supervise non-medical prescribers and clinical pharmacists.
• Provide additional support to reception and management staff.
• Continue to identify and implement changes to improve the GP national patient survey results.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care