Archived: Cliff House Medical Practice

Updated 23 January 2017

Cliff House Medical Practice provides primary medical services to approximately 5,504 patients in the city of Lincoln and surrounding villages. The practice has a branch surgery located in Lincoln which is situated close to the University of Lincoln and areas of student accommodation.

The practice is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures and maternity and midwifery services.

At the time of our inspection, the practice employed one male GP partner, three GPs (one male and two female), a business partner, a practice manager, two practice nurses, one health care assistant, a senior receptionist and three reception staff, one member of reception was also a phlebotomist.

Cliff House Medical Practice is open from 8am until 6.30pm Monday to Friday with the exception of a Monday when the practice is open until 8pm.

The practice delivers teaching sessions to medicals students on a rotational basis who are enrolled with the University of Nottingham. The practice is a training practice for nurse students who are enrolled with the University of Lincoln. Members of the nursing team are trained to support student nurses during placement with the practice.

The practice is a registered research centre with the ‘Primary Care Research Network’ and the ‘East Midlands Clinical Research Network’.

The practice is an accredited yellow fever centre which is registered with NATHNaC (National Travel Health Network and Centre).

The practice has a Personal Medical Services (PMS) contract. The PMS contract is the contract between general practices and NHS England for delivering care services to local communities.

The practice has a higher population of patients between the ages of 20-44 years of age.

The practice has an active patient participation group (PPG) who meet on a regular basis.

The practice offers on-line services for patients including ordering repeat prescriptions and booking routine appointments.

The practice has opted out of the requirement to provide GP consultation when the surgery is closed, the out-of-hours service is provided by Lincolnshire Community Health Services NHS Trust.

Updated 23 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cliff House Medical Practice on 11 August 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 and recording significant events.

• Risks to patients were assessed and well managed. The practice had a risk register in place.

• The practice delivered teaching sessions to medicals students on a rotational basis who were enrolled with the University of Nottingham. The practice was a training practice for nurse students who were enrolled with the University of Lincoln.

• The practice was a registered research centre with the ‘Primary Care Research Network’ and the ‘East Midlands Clinical Research Network’.

• 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.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients 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.

• The practice was an accredited yellow fever centre which was registered with NATHNaC (National Travel Health Network and Centre).

• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 January 2017

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

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

• Performance for diabetes related indicators was 100% which was higher than the national average of 89%. (This included an exception reporting rate of 20%).

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and 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 23 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.

• 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.

• The practice’s uptake for the cervical screening programme was 75%, which was comparable to the CCG average of 78% and the national average of 74%.

• Childhood immunisation rates for the vaccinations given were mixed compared to CCG/national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 87% to 97% and five year olds from 63% to 100%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice provided a confidential sexual health advice and chlamydia screening service called the ‘c-card scheme’ for patients aged between 13 and 24 years of age.

Updated 23 January 2017

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 people in its population.

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

• Patients received personalised care plans from a named GP to support continuity of care.

Updated 23 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 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.

• The practice offered extended hours appointments until 8pm on a Monday evening each week with both GPs and nurses.

• The practice offered a text reminder service for booked appointments.

Updated 23 January 2017

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

• Performance for mental health related indicators was 93% which was comparable to the national average of 93%.

• 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.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

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

• Some members of the reception team had completed mental health awareness training and other members of staff were ‘dementia friends’.

• The practice held regular in-house mental health awareness days for patients in conjunction with the PPG.

Updated 23 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 homeless people, travellers and those with a learning disability.

• 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 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.

• The practice provided food bank vouchers to patients who were vulnerable and in need to ensure themselves and their families had food.