5 December 2017
The New Dispensary moved into a purpose built building in 2008 which offers a good level of access to both floors via a lift as well as offering disabled parking, a lowered desk and toilet facilities. The practice provides care to a current list size of 6911 patients through a General Medical Services (GMS) contract.
The practice is in an area of low deprivation with levels of deprivation affecting children and older people significantly lower than the national average but in line with the Clinical Commissioning Group (CCG) area. The practice is registered to provide the following regulated activities: surgical procedures, family planning, diagnostic and screening procedures, maternity and midwifery services; and treatment of disease, disorder or injury.
The clinical team comprises of:
- Two male and two female GP partners.
- Two practice nurses and a health care assistant (HCA)
The clinical team is supported by a practice manager and a team of secretarial, reception and administrative staff. This practice provides teaching and training for doctors who wish to become GPs. (Trainee GPs are qualified doctors undertaking a period of additional training to qualify as a GP).
The main surgery opens from 8.30am to 6.30pm Monday to Friday although the telephone system opens at 8am. Consulting times are from 8.40am to 12.30pm each morning and from 3.30pm to 5.30pm each afternoon. For patients who find it difficult to attend during normal working hours the practice offers booked appointments on Saturday mornings between 8am and 11.30am.
The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Care UK and is accessed via 111.
5 December 2017
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The New Dispensary on 11 January 2017. The practice was rated requires improvement for providing safe services with an overall rating of good. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for The New Dispensary on our website at www.cqc.org.uk.
This inspection was a follow up focused inspection carried out on 31 October 2017 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 11 January 2017. This report covers our findings in relation to those requirements.
We found the practice had taken action to address areas where improvements were needed. The practice had made extensive changes which had resulted in significant improvements.
Our key findings were as follows:
Effective systems and processes had been implemented to ensure patients who were prescribed high risk medicines received monitoring in line with national guidance.
The system for tracking and monitoring prescriptions for controlled drugs had been improved and enabled effective monitoring.
The practice is now rated as good for providing safe services.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
27 March 2017
The practice is rated as good for the care of people with long-term conditions.
- Clinical 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 92.3% which was 4.8% below the CCG average and 2.4% above the national average. The exception reporting rate for diabetes indicators was 4.6% which was below the CCG average of 10.2% and the national average of 11.6%.
- Regular medicines and pharmacy reviews were completed.
- Longer appointments and home visits were available when needed which included flu vaccines and reviews.
- All these patients had a named GP and were offered a structured annual review to check their health and medicines needs were being met.
- For patients with the most complex needs, practice staff worked with relevant health and care professionals to deliver a multidisciplinary package of care. Regular multidisciplinary meetings were hosted by the practice and a nurse acted as a care coordinator to ensure continuity of care for patients.
27 March 2017
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 child safeguarding lead and staff were aware of who they were.
- There were dedicated child flu vaccine clinics organised around school hours for patient convenience.
- Immunisation rates were higher than local averaged for all standard childhood immunisations and the practice worked with health visitors to follow up children who did not attend for immunisations.
- There were child changing facilities and a room was available for breast feeding if required.
- The practice offered a full range of contraception services including coil fitting and implants.
- Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
- Urgent appointments were available on a daily basis to accommodate children who were unwell.
27 March 2017
The practice is rated as good for the care of older people.
- Care plans were shared with out of hours services and emergency services to ensure care was in line with patients’ wishes and to assist in clinical decision making when the practice was closed.
- There was an ‘over 90’s’ register to allow for regular review of care and treatment plans.
- The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs which included nurse appointments and flu vaccines.
- A designated GP conducted telephone rounds to local care homes to allow for regular monitoring of patients.
- Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure were in line with or above local and national averages.
27 March 2017
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.
- Appointments could be made and cancelled on line as well as management of repeat prescriptions.
- The practice offered a Saturday morning clinic for those who were unable to attend in the week.
- The practice released health information through social media and encouraged exercise through a staff and patients group.
27 March 2017
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 1.8% above the CCG average and 7.2% above the national average. The exception reporting rate for mental health related indicators was 3.5% which was below the CCG average of 9.3% and the national average of 11.3%.
- The number of patients with a diagnosis of dementia who had their care reviewed in a face-to-face review in the last 12 months was 100% which was 13.4% above the local average and 16.2% above the national average. This was achieved with an exception reporting rate of 2.9%, 2.7% lower than the CCG average and 3.9% below the national average.
- The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
- The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
- Staff had a good understanding of how to support patients with mental health needs and dementia and some patients had weekly or monthly reviews timetabled.
27 March 2017
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.
- The practice offered longer appointments for patients with a learning disability and for those who required it.
- The practice regularly worked with other health care professionals in the case management of vulnerable patients. Regular multidisciplinary meetings were hosted by the practice. In addition the practice held regular gold standard framework meetings to discuss patients on their palliative care register.
- Staff knew how to recognise signs of abuse in vulnerable adults and children and had undergone prevent training. 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.