Archived: Shanklin Medical Centre

Updated 27 February 2018

Shanklin Medical Centre is located in Carter Road, Shanklin, Isle of Wight, PO37 7HR. The practice is close to the centre of Shanklin. Shanklin Medical Centre is part of the Isle of Wight Clinical Commissioning Group (CCG).

The practice website can be found at www.shanklinmedicalcentre.nhs.uk

The practice provides a range of primary medical services to approximately 11,600 patients.

Shanklin Medical Centre has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The Isle of Wight CCG covers an area where the average age is older when compared with the average for England. Shanklin Medical Centre has a significantly higher percentage of their practice population over 65 years of age compared with the average for England, with the number of patients over 85 years of age almost twice the average for England. The level of deprivation is equal to the average level of deprivation for England.

Updated 27 February 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection March 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? - Good

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 – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

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

We carried out an announced comprehensive inspection at Shanklin Medical Centre on Thursday 23 November 2017 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. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice worked with other agencies to support patients and protect them from neglect and abuse. Staff took steps to protect patients from abuse, neglect, harassment, discrimination and breaches of their dignity and respect.
• The practice used text messaging reminders for appointments and if they had consent from the patient, results of blood tests for example would also be sent using this method. This helped to improve treatment and supported patients’ independence.

We saw some areas of outstanding practice:

At this inspection we found that the practice had continued to be outstanding in responding to people’s needs.

The practice continued to initiate positive service improvements for its patients that were over and above its contractual obligations. It acted on suggestions for improvements and changed the way it delivered services in response to feedback from the patient participation group. For example by offering patients alternative means of accessing their GP or meeting their healthcare needs. The practice reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group (CCG) to secure service improvements where these had been identified. The practice played a significant role in instigating health initiatives and worked with the CCG and other practices to secure funding for enhanced services for patients.

For example; Results from the July 2017 annual national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was higher than local and national averages. The practice had scored higher than the clinical commissioning group averages in every question. This was supported by observations on the day of inspection and completed comment cards.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 May 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication 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.

The practice had nurse led clinics supported by GPs to manage the health and treatment of patients with long term conditions. The nurse led diabetes team made regular visits to each of the care homes covered by the practice. This was done to support care home staff in the management of these patients. The nurses had reassessed the needs of these patients and ensured medicines were reviewed to meet the changing needs of these patients.

Updated 28 May 2015

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 accident and emergency (A&E) attendances. The practice had safe systems in place to highlight on the electronic clinical system those children at risk. These alerts had also been linked to other family members’ records.

Immunisation rates were relatively high for all standard childhood immunisations. 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working health visitors.

In response to a national audit into children’s accidental injuries one of the GP partners had designed a poster campaign to highlight risks that lead to A&E attendance. This poster was then distributed to all children’s centres across the island and, at the practice’s expense, published in the island’s newspapers.

Updated 28 May 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Each patient over 75 years of age had a named GP responsible for their care. The practice had introduced a nurse led service for these patients. The lead practice nurse made telephone calls to all patients in this age group if they had not had any contact with the practice in the preceding three months. This was to check they did not have any concerns or worries about their health or welfare. The nurse also contacted these patients by telephone on their discharge from hospital.

Patients in care homes were visited weekly by the GP allocated to the home, these visits were not part of an agreement with commissioners or the care home. This provided continuity of care for these patients and better communication with care home staff. The practice nurses and GPs had provided training for care home staff to support them in the assessment and monitoring of the people in their care.

Updated 28 May 2015

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 had extended hours opening to meet the needs of those patients who needed to attend outside normal working hours. The practice was open every Monday until 8pm and every Saturday morning. The practice had introduced e mail consultations for those patients for whom it had been pre-arranged. These were mainly for follow up consultations when face to face consultations were not necessary or telephone consultations not convenient.

Updated 28 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice had a GP lead for patients experiencing poor mental health.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It 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 received training on dementia awareness as part of an island training afternoon.

Updated 28 May 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice was aware of patients living in vulnerable circumstances including homeless people, and those with a learning disability. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability. The practice had proactively worked to improve the uptake of annual health checks for patients with a learning disability. They had sent letters to those patients cared for in their own home with a personal invitation for an annual health check. This had resulted in an increase in the number of patients attending. It also gave the practice nurses and GPs opportunity to provide help and support to these patients to maintain a healthy life style.

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 provided care for a number of patients with no fixed address. They practice address was used for any referrals or prescriptions these patients needed. Staff knew these patients well and were aware of the arrangements in place for their registration with the practice.

The practice had sufficient resources to meet the needs of the increased population on the Isle of Wight during the holiday season. They had been able to deal with 2000 contacts with temporary residents in the past year.