Archived: Dr Simon John Shaw

Updated 27 September 2016

Dr Simon John Shaw is located at Geoffrey Street Health Centre a health centre approximately one mile from the centre of Preston in a residential area. The centre is owned and maintained by NHS Property Services. There is easy access to the building and disabled facilities are provided. There is car parking available on site.

Primary medical services are provided under a General Medical Services (GMS) contract with NHS England and the practice is part of the Greater Preston Clinical Commissioning Group.

There is one GP working full time at the practice. He is the provider of the service and nine sessions are available each week. There are two part-time female practice nurses one of whom was on long term sick leave on the day of our inspection. There is a part time practice manager and a small team of administrative staff.

The practice opening times are 8.30am-6pm Monday, Tuesday, Wednesday, 8.30-1pm Thursday and 8.30am-5.30pm on Friday. The practice appointment times are Monday to Friday 9-11am, Monday 4-6pm, Tuesday and Wednesday 3-5pm and Friday 2-4pm. Due to the implementation of a new GP contract the practice will be open Monday to Friday 8.30am – 6.00pm and access by telephone available from 8.00am – 6.30pm from 1st October 2016. Patients requiring a GP outside of normal working hours are advised to call Preston Primary Care Centre using the usual surgery number and the call will be re-directed to the out-of-hours service.

There are 1872 patients on the practice list. The majority of patients are white British with 15% who are from other ethnic groups including Asian and Eastern European. There are a high number of working age patients and families. The practice is in a highly deprived area, rated at “1”, the most deprived decile.

Updated 27 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Simon John Shaw on 19 July 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. Although there was a stable staff team established, for future recruitment purposes we noted there was no formal recruitment policy. This should be implemented to include the information required in the recruitment checklist.

• Systems were in place for reporting and recording significant events.

• Risks to patients were assessed and well managed. However infection control was not being regularly audited.

• 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.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment with the GP and that 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 and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvements :

• Ensure a formal recruitment policy is implemented which includes the information required in the recruitment checklist.

• Maintain security in unauthorised areas.

• The practice should promote online services to all patients.

• The practice should develop a patient reference group in order to consult more widely about patient views and experiences and seek relevant improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 September 2016

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

The chronic disease programme was robust and included:

• Annual review or six month call and recall programme with a clinician for all patients with chronic disease.

• The Practice nurse undertook the review of patients with chronic disease including diabetes and chronic obstructive pulmonary disease (COPD).

• Annual medication reviews for all patients on repeat medication, with robust procedures for non-compliant patients.

• Longer appointments were offered for patients with multiple conditions.

• Home visits carried out by the GP and practice nurse for house bound patients with chronic disease.

• Flu immunisations for all patients with long term conditions. 100% of people with diabetes had this immunisation in comparison with 93% across the Clinical Commissioning Group ( CCG) and 94% England average.

• The practice offered diabetic foot screening call and recall. CQC data indicated that the practice achieved 97% for annual foot checks in patients with diabetes compared to the national average of 88%.

• Continuity of care was delivered by patients seeing the same GP thereby reducing consultation time and allowing more time for the presenting problem that day. The GP had experience of what previous treatments had been the most effective with that patient.

The prescription administrator oversaw the repeat dispensing scheme where patients were prescribed a six month supply of medicine . The GP reviewed all patients or ensured blood tests had been screened before the prescription was renewed.

Updated 27 September 2016

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

• The practice had high achievement with their childhood immunisation programme. Immunisation performance was discussed with the safeguarding lead and when available the health visitor.

• There were safeguarding procedures in place for children who were vulnerable. All staff received regular safeguarding training. The GP was the lead for child & adult safeguarding.

• Childhood flu immunisations were offered and promoted via posters in the waiting room.

• The community midwife undertook clinics at the practice and liaised with the GP and practice nurse.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and younger patients who had a high number of A&E attendances.

• 94% of patients with asthma, on the practice register, had an asthma review in the preceding 12 months that included an assessment of asthma control using the three Royal College of Physicians (RCP) questions. This compared to a CCG average of 76% and a national average of 75%.

• 80% of women aged 25-64 were recorded as having had a cervical screening test in the preceding 5 years.This compared to a CCG average of 80% and a national average of82%.

• There was immediate access to same day appointments for all children where required.

• There were pre-bookable appointments one week in advance to help families plan ahead.

• Appointments were available with the GP until 5pm on two afternoons and 6pm on one afternoon so that families could attendafter school hours.

• A female health service was available and smears were carried out at the surgery.

Updated 27 September 2016

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

• The practice offered proactive, personalised care to meet the needs of the older patients.
• The practice offered home visits and same day appointments for those with enhanced needs.
• Care plans and health checks were provided as needed with regular medicine reviews carried out.
• The practice supported patients who lived in nursing and residential homes by undertaking home visits when needed and providing advice over the telephone.
• The practice offered flu, pneumonia and shingles vaccination programmes.

.

• Where the patient was at risk of Emergency Admission to hospital a Care Plan was created for them as part of the Alternative to Unplanned Admission Enhanced Service. The patient was given a copy of the plan to keep by the phone in case they required medical assistance urgently.

• The practice worked closely with the Palliative Care Nurse Specialist, Community Nurse Team and Community Matron.

• Very elderly/housebound patients were able to order repeat medication over the phone and home delivery of medication by the pharmacist was promoted.

Updated 27 September 2016

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

.

• Appointments were available until 6pm on Mondays. Patients could book routine appointments up to one week in advance both on the telephone and online.

• The practice promoted online services to selected patients to make it easier for patients who worked to access services outside of practice hours.

• Health Checks were available to patients over 40 years.

• Telephone consultation was available during working hours.

• Electronic Prescription Services (EPS) and a repeat dispensing service helped patients to get their prescriptions easily.

• Travel health and vaccination appointments were available.

Updated 27 September 2016

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

• The practice had leaflets and posters in the waiting room with information regarding dementia, mental health and carer support.

• Patients were monitored as part of the Quality and Outcomes Framework ( QOF) to check that they had an up-to-date care plan from the Mental Health Team. 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months.This compared well to a CCG average of 86% and a national average of 88%.

• 100% of patients diagnosed with dementia had their care reviewed in a face-to-face review in the preceding 12 months. This was higher than the national 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 surgery assessed anxiety and depression usingeffective recognised screening tools. Once patient records were coded as indicating anxiety or depression the patients were then followed up at between 2-6 week appointments.

• All patients at risk of dementia were screened using a nationally recognised screening tool. If results indicated a diagnosis of dementia a referral to the memory clinic was organised.

Updated 27 September 2016

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

• Patients with a learning disability or other significant disability were known to the practice nurse and GP which meant staff could quickly identify when dealing with a patient that they may require additional assistance. They were offered an annual health check using the Cardiff Care Plan often with a support worker present. Picture cards were used to support people with poor understanding of language.
• The practice had a register of vulnerable adults and children so that staff were alerted when they attended for appointments. This included 23 patients identified as carers.
• Clinical staff were trained in the mental capacity act. There were procedures in place for identifying patients with a Deprivation of Liberty Safeguard (DOLS) in place.

• The practice regularly worked with multi-disciplinary teams in the case management of patients deemed to be vulnerable.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice had a hearing loop to assist patients with hearing loss.

• Language line was used with patients where English was not their first language and reception & nursing staff used a quick translation poster to communicate about basic health questions. .