Archived: RJ Mitchell Medical Centre

Updated 21 May 2015

RJ Mitchell Medical Centre is located in Talke, Stoke On Trent and is part of the NHS North Staffordshire Clinical Commissioning Group. The practice has a branch practice, Waterhayes Surgery located at Crackley Bank, Newcastle, Staffordshire. The total practice patient population is 4344. The practice is in an area considered as a fifth more deprived when compared nationally. People living in more deprived areas tend to have greater need for health services.

The staff team currently comprises two male partner GPs each providing full day practice sessions and a female partner. The practice team includes a practice manager, two practice nurses, a senior receptionist and nine reception/administration staff. Excluding the GPs there are 13 staff in total employed either full or part time hours.

RJ Mitchell Medical Centre opening times are Monday 8am to 7.30pm, Tuesday to Friday 8am to 6.30pm with the exception of Thursdays when the surgery times are 8am to 1pm at the Waterhayes Surgery and 8am to 1pm at the RJ Mitchell Medical Centre, Talke.

The practice does not provide an out-of-hours service to its own patients but has alternative arrangements for patients to be seen when the practice is closed through the Staffordshire Doctors Urgent Care service.

The practice has a General Medical Services (GMS) contract with NHS England. This is a contract for the practice to deliver general medical services to the local community or communities.

Updated 21 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at RJ Mitchell Medical Centre practice on 11 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, responsive and caring services. It was also rated as good for providing services for all population groups.

Our key findings were as follows:

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• 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.

We saw an area of outstanding practice:

• Any patients who deliberately self-harmed were identified from A&E discharges and were invited for mental health assessment and support.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Ensure the completion of criminal record checks using the Disclosure and Barring service (DBS) prior to the commencement of clinical staff working with patients.

• Ensure prescribers on home visits, before leaving the practice premises, record the serial numbers of any prescription forms/pads they are carrying as per NHS Protect Guidance, August 2013.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 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 people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 21 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 A&E attendances. 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 with midwives and health visitors.

Updated 21 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 and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Older people with complex needs such as having a long term condition or those on multiple medicines had care plans in place. As part of the Directed Enhanced Services (DES) the patients with care plans had access to the practice and to their nominated GP by a separate telephone line. (DES are schemes that commissioners are required to establish or to offer contractors the opportunity to provide, linked to national priorities and agreements.) The GP informed us the separate line was responded to as soon as practicable. Should these patients be discharged from hospital, then the GP telephoned within 72 hours to ensure that they had necessary medication as well as the social care to support their health and wellbeing.

Updated 21 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 opened for an additional hour each Monday at each location until 7.30pm to improve access for working age people.

Updated 21 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All patients with a mental health care plan had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice maintained a register of patients with dementia and was involved with multidisciplinary teams such as the Integrated Local Care Team (ILCT), to support patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND and SANE. (MIND and SANE are mental health support charities which aim to provide advice and support to empower anyone experiencing mental health problems). It 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.

We saw for example that any patients who deliberately self harmed were identified from A&E discharges and were invited for mental health assessment and management. These patients were highlighted on the practice computer system. As part of the practices innovation to improve services for their patients, a mental health counsellor had a weekly surgery to support people with poor mental health.

Updated 21 May 2015

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. Patients were offered an annual physical health check. Practice records showed they had received a check up in the last 12 months. The practice used a read code system to ensure they held recorded details of patients’ carers or the people involved in supporting them. There were a small number of patients with a learning disability registered at the practice and were therefore well known to staff.

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.