The Flying Scotsman Centre

Updated 14 July 2017

The Flying Scotsman Centre is located in the town centre of Doncaster near to the train station. The practice provides services for 10,576 patients under the terms of the NHS Alternative Provider Medical Services contract. The practice is run by The Practice Surgeries Limited who have other locations throughout the country registered with Care Quality Commission.

The practice catchment area is classed as within the group of the most deprived areas in England. The age profile of the practice population differs from other practices in the area. The practice has 4% more children aged 0 to 4 years old and 14 to 18 years old registered. There are 26% less persons aged from 65 years and above registered here compared to other practices in the area.

The practice has one female GP who is supported by a long term male sessional GP and a pharmacist practitioner. They are supported by a lead nurse practitioner, an advanced nurse practitioner, two practice nurses, two healthcare assistants, a practice manager and a team of reception and administrative staff.

The practice is open between 8am to and  8pm every day of the year.  Appointments are available throughout the day with a variety of staff. Appointments with the practice nurse are available every alternate Saturday. In addition to pre-bookable appointments that could be booked up to four weeks in advance, same day appointments with GPs and advanced nurse practitioners were available for patients that needed them.

In addition to pre-bookable appointments that could be booked up to four weeks in advance, urgent appointments we are also available for people that needed them. When the practice is closed calls we are answered by the out-of-hours service which is accessed via the surgery telephone number or by calling the NHS 111 service. 

The provider also is also commissioned to offer the violent patient scheme providing a secure environment in which patients who have been violent or aggressive in their GP practice can receive general medical services. The service is accessed via a dedicated telephone number and the patient can choose whether to request a face-to-face consultation with a GP or a telephone consultation. Face-to-face consultations are held twice a week in appropriate secured rooms with sufficient security staff on the premises half an hour before the patient’s appointment and leave at least half an hour after the patient has left the premises.

Updated 14 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Flying Scotsman Centre on 9 May 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• To review the set up of staff details on the patient record system to allow individual prescriber names to be produced on electronic prescriptions.
• Continue to canvass patients to establish their caring responsibilities and offer further guidance and support to those identified as carers. 

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 14 July 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority. 
• Patients with multiple long term conditions attended one appointment to review all of their conditions rather than attending for several appointments.
• Performance for diabetes had improved and the practice had achieved 93% of the outcomes available for the year 2016/17.
• The practice followed up on patients with long term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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.

Updated 14 July 2017

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

• From the examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.
• Immunisation rates were improving for all standard childhood immunisations.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 14 July 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified, at an early stage, older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services. For example, with community matrons.

Updated 14 July 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations 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 was open until 8pm on weekdays and every Saturday and Sunday from 8am to 8pm.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 14 July 2017

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

• The practice carried out advance care planning for patients living with dementia.
• Performance for dementia related indicators was 100%.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia. 
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• Performance for mental health related indicators was 82%.
• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 14 July 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 homeless people, travellers and those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• 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 information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.