The Scott Practice

Updated 27 June 2018

The Scott Practice is situated within a purpose built health centre in Balby near Doncaster. The practice also provides services at a branch site at The Scott Practice Village Surgery, Main Street, Sprotbrough, Doncaster, DN5 7RH. We only visited the main site as part of this inspection.

The practice provides General Medical Services (GMS) for 14,262 patients. The clinical staff team work across both sites. There are nine GP partners, six male and three female, a managing partner/practice manager and a salaried GP. They are supported by a pro-active care nurse, two practice nurses, an advanced nurse practitioner, three healthcare assistants and a pharmacist. An experienced team of administrative and reception staff support the practice at both sites.

The practice opening hours at the Balby site are:

• 8am to 6.30pm Monday, Thursday and Friday
• 8am to 7pm on Tuesday
• 7am to 6.30pm on Wednesday.

The Sprotborough site is open Monday to Friday 8am to 12.30pm and open until 4.30pm on two afternoons a week, days of which may vary.

The practice leaflet and web site include details of surgery and GP appointments times. GP appointments are available from 8.00am to 5.30pm each weekday, with extended appointment times on Tuesday mornings and evenings. Routine and specialist clinics such as long term condition management, minor surgery, ante-natal and family planning are also available.

Out of hours care can be accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 27 June 2018

This practice is rated as Outstanding overall.

(Previous inspection January 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Outstanding

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Outstanding

People experiencing poor mental health (including people living with dementia) - Good

We carried out an announced comprehensive inspection at The Scott Practice on 21 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was always delivered according to evidence- based guidelines. 
• Those whose circumstances made them vulnerable, frail older people and those with multiple long term conditions were well supported by the practice who employed a pro-active care team.
• Staff involved and treated patients with compassion, kindness, dignity and respect.The practice was above average for its satisfaction scores on consultations with GPs and nurses.
• Recent improvements had been made to the telephone system and patients found it easy to use the appointment system and reported that they were able to access care when they needed it.
• There was innovation and service development and improvement was a priority among staff and leaders.
• At the core of the practices ethos, was learning and development across all staff groups.

We saw areas of outstanding practice:

• The practice used innovative and proactive methods to improve patient outcomes and worked with other local providers to share best practice. In October 2016 the practice linked with six neighbouring practices to hold quarterly meetings with the wider multidisciplinary team which included a respiratory nurse, community geriatrician, a representative from the local social prescribing initiative, palliative care nurses, district nurses, heart failure nurse, social services and the falls team. This provided the opportunity to review those patients considered most at risk and a forum for sharing best practice and learning through review of case studies.
• The practice ensured that patients with complex needs, including those with life-limiting progressive conditions, were supported to receive coordinated care in innovative and efficient ways.The practice employed a care co-ordinator nurse to review and implement care plans for those patients whose circumstances may make them vulnerable. Initially, patients were assessed using a risk stratification tool which included review of patients living with dementia, learning difficulties, frailty, at risk of hospital admission, housebound, residing in care home or those with multiple long term conditions. The care co-ordinator had identified 255 patients at risk and 89% of these patients had agreed care plans in place.
• There was compassionate, inclusive and effective leadership at all levels. All leaders demonstrated high levels of experience, capacity and capability needed to deliver excellent and sustainable care.
• There was a demonstrated commitment to best practice performance and risk management systems and processes. The practice reviewed how they functioned to  ensure that staff at all levels have the skills and knowledge to use those systems and processes effectively. Problems were identified and addressed quickly and openly.

The areas where the provider should make improvements are:

• Review monthly checks of emergency medicines and consider completing a risk assessment in the absence of keeping a stock of Atropine, a medicine to treat slow heart beat.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 June 2018

Updated 27 June 2018

Updated 27 June 2018

Updated 27 June 2018

Updated 27 June 2018

Updated 27 June 2018