Archived: Dr Kieran McCormack Also known as Worthen Medical Practice

Updated 9 April 2015

The Dr. Kieran McCormack practice is located in Worthen, Shropshire, and is part of the NHS Clinical Commissioning Group (CCG) Shropshire. The total registered patient population is 2,036.

The clinical staff team currently comprises of a male and female GP, a practice nurse who works 25 hours per week and a healthcare assistant (HCA). The HCA also carries out phlebotomy (blood taking) and NHS Health Checks for patients at the practice when requested to do so by the practice. The Lead male GP provides 8 sessions per week at the practice and salaried female GP provides 4 sessions.

The practice is a dispensing practice and employs a dispenser/ manager who is employed for 32 hours a week. Working alongside the clinical staff is a practice manager who works 20 hours per week. The practice has a dispenser/reception staff member employed for 37.5 hours per week, a dispenser /secretary 20 hours per week, a practice administrator 24 hours per week and part time cleaning staff.

Clinics run by the practice include amongst others; child development, minor surgery, long term condition management which includes a wide range of conditions, for example; diabetes, heart disease and hypertension (high blood pressure) and travel clinics. The Chiropodist provides a clinic on Tuesday afternoons every month by appointment and only after referral by the GP.

The percentage of patients that would recommend the practice to someone new to the area (July 2014 National Patient Survey) is 95% which compares favourably with the practice average across England of 79%.

Practice opening times are from 08.30am to 6pm with the exceptions of Thursday when it opens from 08.30am to 12pm. On Mondays the practice offer an extended service from 08.30am to 7pm. Morning surgeries are run as open surgeries and patients seen in order of arrival and by appointment at reception unless prioritised as an emergency. The practice offers a patient appointment service following the open surgery each day. When the surgery is closed the care and treatment needs of patients are met by the out of hours provider, Shropdoc.

The practice was inspected by the Care Quality Commission in May 2013 under our previous methodology and judged to be compliant.

Updated 9 April 2015

Letter from the Chief Inspector of General Practice

We inspected Dr. Kieran McCormack’s practice, also known as Worthen Medical Practice on the 26 November 2014. We inspected this practice as part of our new focused, comprehensive, inspection programme.

We looked at how well the practice provided services for specific groups of patients. These included; older patients, patients with long-term conditions, families, children and young people, working age patients (including those recently retired and students), patients living in vulnerable circumstances and patients experiencing poor mental health (including people with dementia).

The overall rating for this practice was good.

Our key findings were as follows:

• There was a clear management structure to support and guide staff to deliver safe, responsive and effective care to patients.
• We found the leadership team was visible. There were good governance and risk management measures in place.
• Patients told us they were treated with compassion, dignity and respect and they were involved in care and treatment decisions.
• The practice provided patients with same day appointments and extended evening appointments every Monday.
• The practice took time to listen to the views of their patients and had an effective, active Patient Participation Group and any actions identified were implemented and used to improve the service.
• Staff had implemented a system to reduce the risk of patients missing their regular reviews for conditions, such as diabetes, respiratory and cardiovascular conditions.
• The practice was working towards the development, agreement and funding for new practice premises in the future. This had been widely consulted on over a ten year period.
• The practice had an in house community care co-ordinator.
• Following home visits, the GP provided an individual medicine dispensing service where necessary for patients that required it.

We saw several areas of outstanding practice including:

• The practice staff were involved with supporting the Compassionate Communities initiative (Co Co). Staff recruited volunteers and co-ordinated support for individuals the impact of which was to improve people’s wellbeing. This is a voluntary organisation that provides support for local people at home, helping them maintain their independence.

However, there was also an area of practice where the provider needs to make improvements.

The provider should:

• Complete a risk assessment in respect of the dispensary security.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 April 2015

The practice is rated as good for the population group of people with long term conditions (LTC).

Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. Longer appointments and home visits were available if required. Systems were in place to carry out structured annual reviews to check patients’ health and medication needs were being met. Where patients had complex health needs the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.

We found staff had implemented a system to reduce the risk of patients missing their regular reviews for conditions, such as diabetes, respiratory and cardiovascular problems. Staff were skilled and regularly updated in specialist areas which helped them ensure best practice guidance was consistently followed.

One staff member employed by the practice was an in house community care co-ordinator. The introduction of care co-ordinators based in GP practices was a CCG initiative, based on providing as much support through community settings, such as is possible to enable patients to live independently for longer. The practice staff were involved with supporting the Compassionate Communities initiative (Co Co). Staff members recruited individual volunteers and co-ordinated support for individuals the impact of which was to improve people’s wellbeing. They are a voluntary organisation that provides support for local people at home, helping them maintain their independence. They provided a befriending service for potentially isolated or unsupported people to assist them to stay connected socially with friends or with local activities.

We saw that patient referrals, hospital letters, blood results and investigations were monitored and managed effectively to provide a seamless a service as possible to the patients.

Updated 9 April 2015

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

The practice met regularly with the health visitor who held a monthly clinic at the practice. Systems were in place to highlight any vulnerable patients within the patients’ electronic records.

We saw that the pregnant mothers’ uptake of flu vaccinations was 100% in 2014 to date.

Appointments were available outside of school hours and the premises were suitable for children and babies. The practice had achieved 100% uptake in MMR childhood immunisations.

The uptake of a cervical smear screening test in women over the age of 25 to October 2014 was 90%.

The practice informed us that the local NHS Trust launched a Family Nurse Partnership (FNP) Service this year, to provide home visiting support to teenage girls aged 19 years and under who are pregnant. This enabled the practice to refer to and liaise with a specially trained family nurse who would visit young mums regularly; from early in pregnancy until the child was two.

Updated 9 April 2015

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

The practice offered proactive personalised care to meet the needs of patients and had a range of enhanced services, for example end of life care. The practice had signed up for the enhanced service (ES) to provide a ‘Proactive Care Program’ in which patients with complex needs were reviewed each month at multi-disciplinary team meetings including end of life palliative care meetings. Avoiding Unplanned Admissions enhanced service (ES) is designed to help reduce avoidable unplanned admissions by improving services for vulnerable patients and those with complex physical or mental health needs, who are at high risk of hospital admission or re-admission including older people. The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The practice staff were involved with supporting the Compassionate Communities initiative (Co Co). Staff members recruited individual volunteers and co-ordinated support for individuals the impact of which was to improve people’s wellbeing. This is a voluntary organisation that provides support for local people at home, helping them maintain their independence. They provide a befriending service for potentially isolated or unsupported people to assist them to stay connected socially with friends or with local activities.

A Joint Strategic Needs Assessment (JSNA) is an on-going process by which local authorities, Clinical Commissioning Groups (CCG) and other public sector partners jointly describe the current and future health and wellbeing needs of its local population and identify priorities for action. According to the JSNA figures the percentage uptake of flu vaccination in people aged 65 and over in Shropshire was 72.8%, which was lower than the national target of 75% and the England average (74%) in the 2011-12 flu season. We saw that Dr Kieran McCormack’s practice had achieved 82% flu vaccination uptake to date in 2014. In the over 65’s the practice percentage uptake for the Pneumococcal vaccine was 86%. Pneumococcus is a bacterium which can cause pneumonia, meningitis and some other infections. The practice had also been very successful in the 70 and 79 year old uptake of the shingles vaccine having achieved 100% in both age groups in 2013.

Updated 9 April 2015

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

The percentage of patients within the practice population of working age (including those recently retired and students) was 58.4% of those registered at the practice.

Patients were able book appointments and request repeat prescriptions using on line services and the practice offered an open, same day appointment system with the GP and an extended hours service on Monday evenings. A range of health promotion and screening services were available which reflected the needs for this age group.

Updated 9 April 2015

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

Registers of people experiencing poor mental health were maintained and patients had annual health checks. Literature and information regarding access to local services was provided to patients and staff were aware of how to refer to and contact the local mental health crisis team.

A register of patients with a diagnosis of dementia was maintained by the practice and staff were proactive in ensuring they maintained details of carers or of named individuals who supported patients within the vulnerable patient groups.

The practice provided information to patients about how to access various support groups and voluntary organisations, including for example MIND. The Patient Participation Group (PPG) at the practice drew to patient’s attention national and local initiatives through their publications and slides. This included for example in October 2014, World Mental Health Day with a focus on Living with Schizophrenia. It also provided contact details for local support groups such as Healthy Friendships group, who support adults who experience emotional distress by one to one befriending, club and group activity and through education, training and exposure to new cultural experiences. Local information was provided for a service called Rethink Shrewsbury Carers Support Group. This group offered information and support relating to mental health through publications, shared experiences and occasional speakers.

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

Updated 9 April 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable.

The practice held a register of patients living in vulnerable circumstances and would include homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and patients had received a follow-up. It offered longer appointments for people with a learning disability and the practice worked in conjunction with the local authority learning disability team to follow up on any non-attendance.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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 offered a minor injury service for both registered and non-registered patients including those in circumstances which may make them vulnerable.