Archived: Brookfield Surgery Also known as Dr P Shanmugam

Updated 29 September 2017

Brookfield Surgery is situated within a purpose built surgery in Valley Health Centre, Dalton. (The practice had a change of legal entity from partnership to sole trader in August 2016 so some data is not yet available.) The provider now is Dr Prabhu Shanmugam.

Brookfield Surgery is situated in a new purpose built premises known as Valley Health Centre. The premises are shared with another GP provider who is also the landlord.

The practice provides Personal Medical Services (PMS) for 2,090 patients in the NHS Rotherham Clinical Commissioning Group (CCG) area. The practice is situated in an area of high deprivation.

There is one male GP who is supported by a practice nurse and a health care assistant. There is a small administration team led by a practice manager. Locum GPs are used as required to support the practice.

The practice is open 8am to 6.30pm except on Tuesday when the practice is open until 7.30pm. Appointments are available 9am to 11.30am and 3.30pm to 5.30pm Monday, Tuesday and Wednesday, 9am to 11.30am Thursday and Friday 9.30am to 11.30am and 2.30pm to 5.30pm. Extended hours appointments are available 6.30pm to 7.30pm on a Tuesday.

When the practice is closed patients are diverted to the NHS 111 service from the practice telephone number.

This service is a teaching practice for medical students attending Sheffield University.

Updated 29 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brookfield Surgery on 16 August 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 systems to minimise risks to patient safety. However, we found some areas for improvement to maintenance of equipment, records of blank prescriptions, medicines and emergency equipment checks and monitoring and follow-up of uncollected prescriptions.

• 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 the majority of 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. The template for recording notifiable incidents did not support the recording of action taken under the duty of candour although there was evidence in complaints records this duty was met.

The areas where the provider should make improvement are:

• Take account of the duty of candour requirements and review the incident recording form so this supports the recording of action taken under the duty of candour.

• Arrangements for minimising risk of infection should be reviewed in relation to the damaged phlebotomy chair.

• Review and improve arrangements for monitoring and follow-up of uncollected prescriptions.

• Systems to identify patients who are carers should be reviewed and improved.

• Continue to monitor and review the number of staff and mix of staff needed to meet patients’ needs.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 29 September 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.

• There were no published results from the Quality and Outcomes Framework at the time of inspection due to the time the practice had been registered. However data from the practice showed high achievement in most areas. The practice had identified where improvements were required and were taking action to improve diabetes care.

• 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.

• 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 29 September 2017

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

• From the sample of documented 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.

• 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.

Updated 29 September 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.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. They were referred to the Rotherham social prescribing team for assessment and support as required.

Updated 29 September 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, for example, extended opening hours with late evening appointments.

• 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 29 September 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.

• The practice had been a dementia friendly practice since registration.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• The practice regularly worked with multi-disciplinary 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 29 September 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.

• 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.