Archived: The Misterton Group Practice Also known as Dr A J Brownson, Dr N A Ahmed

Updated 30 April 2015

Misterton Group Practice is located in the rural area of Misterton approximately ten miles from the centre of Bawtry. The building is owned by the practice and has good parking facilities and disabled access. The practice also has a satellite branch based in Gringley-on-the Hill. This was visited as part of this inspection.

The practice is registered with the CQC to provide the following regulated activities: Maternity and midwifery services; Diagnostic and screening procedures; Treatment of disease, disorder or injury; and Surgical procedures. It provides patient care for 5907 patients under a general medical services (GMS) contract with NHS England in the Bassetlaw Clinical Commissioning Group (CCG) area.

The practice has two GP partners (male), one advanced nurse practioner (female), two practice nurses, one healthcare assistants, four dispensers and an experienced administration and reception team. The reception team consists of one practice manager and 10 reception and administrative staff.

The practice is open Monday to Friday from 8:30 am to 6:30 pm. The Gringley-on-the Hill site is open Monday to Fridays 8:30am to 12:30 noon and Monday and Tuesday 6:30 to 8pm.

The practice treats patients of all ages and provides a range of medical services. When the practice is closed patients can access the out of hour’s provider service of Derbyshire Health Care.

The practice population is made up of a predominately older and working age population between the ages of 40-70 years. Fifty three per cent of the patients have a long-standing health condition.

The CQC intelligent monitoring placed the practice in band 6. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on the indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice; this only comes after a CQC inspection has taken place.

Updated 30 April 2015

We carried out an announced inspection visit on the 4th March 2015. The overall rating for the practice is good. Specifically, we found the practice was good in providing: safe, responsive and effective care for all of the population groups it serves.

Our key findings were as follows:

• Where incidents had been identified relating to safety, staff had been made aware of the outcome and action was taken where appropriate, to keep people safe.
• All areas of the practice were visibly clean and where issues had been identified relating to infection control, action had been taken.
• Patients received care according to professional best practice clinical guidelines. The practice had regular information updates, which informed staff about new guidance to ensure they were up to date with best practice.
• The service ensured patients received accessible, individual care, whilst respecting their needs and wishes.
• We found there were positive working relationships between staff and other healthcare professionals involved in the delivery of service. Evidence we reviewed demonstrated patients were satisfied with how they were treated and this was with compassion, dignity and respect. It also demonstrated the GPs were good at listening to patients and gave them enough time.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 30 April 2015

The practice is rated as good for the care of patients with long-term conditions.

There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check 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.

We found the practice completed full health checks on new patients and follow on support for any identified health needs. Special clinics for health needs such as, diabetes and asthma were held and systems were in place to identify patients who met the criteria to attend.

Updated 30 April 2015

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

There were systems in place to identify and follow up children living in disadvantaged circumstances and may be at risk, for example, children and young people who failed to attend appointments or clinics. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 30 April 2015

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

Nationally reported data showed 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. They had a range of enhanced services, for example in dementia support. They were responsive to the needs of older people, and offered home visits, longer and rapid access appointments for those with enhanced needs.

Updated 30 April 2015

The practice is rated as good for the care of working-age patients (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 had extended opening hours through the week to support this patient group. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 30 April 2015

We saw the practice monitored patients with poor mental health; they used audits to help ensure patients had a regular physical health check and follow ups if there was non-attendance.

The practice offered structured reviews to all patients with severe and enduring mental health conditions with at least annual reviews of their physical and mental health, medicines and revision of their agreed care plan. A mental health support group was held at the practice.

Updated 30 April 2015

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

The practice held a register of patients with learning disabilities and carried out annual health checks for this group. The practice also offered longer appointments for vulnerable patients.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. We saw evidence of practice staff advising and signposting vulnerable patients to access various support groups and voluntary organisations.