Archived: Dr Claire-Louise Hatton Also known as The Jubilee Practice

Updated 11 October 2017

Dr Claire-Louise Hatton provides primary medical services to approximately 2300 patients through a general medical services contract (GMS).

The practice is located in purpose built premises in the village of Lowdham on the outskirts of Nottingham. A GP surgery has operated from the locality since the 1940s. The practice is co-located with another GP practice. The practice was able to offer dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy.

The level of deprivation within the practice population is significantly below the national average with the practice population falling into the least deprived decile. Income deprivation affecting children and older people is significantly below the national average. The practice serves above average levels of older patients.

The clinical team comprises one GP partner, one salaried GP, one long-term locum GP (all female), a practice nurse and a healthcare assistant. The practice is a teaching practice for medical students accommodating first, second, fourth and final year student placements.

Support for the clinical team is provided by a practice manager and a team of reception and administrative staff. The practice also employs a lead dispenser and a dispenser.

The practice opens from 8.30am to 6.30pm on Monday, Tuesday, Wednesday and Friday. The practice opens from 8.30am to 12.30pm on Thursdays. Surgery times are variable but morning surgery generally runs from 8.50am to 10.50am each morning and from 3.20pm to 5.10pm.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by NEMS and is accessed via 111.

Updated 11 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Claire-Louise Hatton on 2 August 2016. The overall rating for the practice was good; however, the provider was rated as requires improvement for providing safe services as the arrangements to ensure the proper and safe management of medicines within the practice were not adequate. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Dr Claire-Louise Hatton on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 9 September 2017. This was to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 2 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice remains rated as good. The rating for the safe domain is now good.

Our key findings were as follows:

• There was a system in place to ensure stocks of medicines were within their expiry date.

• Storage arrangements for controlled drugs (medicine that require extra checks and special storage because of their potential for misuse) had been improved.
• Security of the premises had been strengthened and steps taken to ensure only authorised individuals could access medicines.

• The storage and security of blank prescription forms had been improved.
• Processes were in place to ensure medicines were stored within the correct temperature range and staff were aware of the importance of maintaining this.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 4 November 2016

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 79.3% which was 8% below the CCG average and 9.9% below the national average. The exception reporting rate for diabetes indicators was 9% which was in line with the CCG average of 10.7% and the national average of 10.8%.
• Performance for indicators related to hypertension was 100% which was 1.1% above the CCG average and 2.2% above the national average. The exception reporting rate for hypertension related indicators was 9% which was above the CCG average of 4.1% and the national average of 3.8%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and were invited for 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 4 November 2016

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

• Systems were in place to identify children at risk. The practice had a dedicated child safeguarding lead and staff were aware of who this was. The safeguarding lead met regularly with the health visitor and other community based staff to discuss children at risk.
• Vaccination rates for childhood immunisations were in line with local averages. For example, childhood immunisation rates for the vaccinations given to five year olds ranged from 94% to 100%.
• Maternity services and baby checks were provided at the practice.
• 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.

Updated 4 November 2016

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

• Personalised care was offered by the practice to meet the needs of its older population. The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Longer appointments were also provided for older people on request.
• The GP and the healthcare assistant visited patients jointly in care homes to ensure patients received medication reviews and to enable them to receive their fly vaccination.
• Patients over 75 had been notified of their named GP.
• Care was provided to three local care homes with regular routine visits, annual reviews and urgent visits where required.

Updated 4 November 2016

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 offered services which were accessible and flexible. For example the practice provided telephone triage and telephone consultations to enable patients who could not get appointments to speak with a GP via telephone.
• The practice was proactive in offering online services including appointment booking and online prescription services.
• A range of health promotion and screening services were offered and promoted that reflected the needs of this age group. Uptake rates for cervical cancer screening, bowel cancer screening and breast cancer screening were above local and national averages.
• A range of services were offered at the practice to facilitate patient access including minor surgery and contraceptive services.

Updated 4 November 2016

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 100% which was 6.2% above the CCG average and 7.2% above the national average. The exception reporting rate for mental health related indicators was 0% which was below the CCG average of 14.8% and the national average of 11.1%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice 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.

Updated 4 November 2016

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 those with a learning disability.
• Longer appointments were offered 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.