Lindum Medical Practice

Updated 4 January 2017

Lindum Medical Practice provides primary medical services to a population of 8,565 registered patients in the city of Lincoln. Lindum Medical Practice is a well-established GP surgery in purpose built premises within a healthcare complex. It has allocated car parking, including disabled access to the right of the main entrance. The main entrance has automated doors and can accommodate wheelchairs, mobility scooters and prams etc. The clinical areas are all on the ground floor. The practice has disabled toilet facilities and a baby changing area on the ground floor. There is also a hearing loop facility available for patients who have hearing difficulties.

Within the waiting area the practice has a glazed 'bubble' area where they can isolate patients who may have an infection or if a patient requests to speak to someone privately. At the time of our inspection the practice employed four GP partners (two male, two female), a practice manager, business manager, an advanced nurse practitioner, four practice nurses, two health care assistants and a team of reception and administration staff. There were also two foundation doctors in post at the time of our inspection.

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

We inspected the following location where regulated activities are provided:- Lindum Medical Practice, 1 Cabourne Court, Cabourne Avenue, Lincoln. LN2 2JP

Lindum Medical Practice is open from 8am until 6pm Monday to Friday. Extended hours are provided for appointments on alternate Monday evenings from 6.30pm until 8pm and on alternate Saturday mornings from 8.30am to 10.30am for pre-bookable appointments only.

The practice is located within the area covered by NHS Lincolnshire West Clinical Commissioning Group (LWCCG). The CCG is responsible for commissioning services from the practice. A CCG is an organisation that brings together local GP’s and experience health professionals to take on commissioning responsibilities for local health services.

The practice has been accredited by the Royal College of General Practitioners (RCGP) in August 2015 as a ‘research ready’ practice enabling them to participate in research and develop a research culture and ethos.

The practice is a training practice and delivers training to F2 doctors (F2 doctors are qualified medical practitioners completing foundation training in general practice).  The practice also delivers teaching to medical students.

The practice offers online services for patients including appointment booking, access to summary care record and also repeat prescriptions EPS (electronic prescription service).

The practice is part of a federation called ‘Imp Healthcare’ which consists of six GP practices who provide services collectively to approximately 55,000 patients in Lincolnshire.

The practice has opted out of the requirement to provide GP consultations when the surgery is closed. The out-of-hours service is provided by Lincolnshire Community Health Services NHS Trust.

Updated 4 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced follow up inspection at Lindum Medical Practice on 25 July 2016. This inspection was a follow-up to our inspection of 23 June 2015 when the practice was rated as ‘requires improvement’. The practice submitted an action plan detailing how they would meet the regulations governing providers of health and social care.

At our follow-up inspection, we found the practice had made improvements in the two domains previously rated as ‘requires improvement’ and overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• 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.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure all policies and procedures are reviewed and updated including the policy in relation to significant events.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 January 2017

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 85% which was comparable to the national average of 89%.

• 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 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 multi-disciplinary package of care.

Updated 4 January 2017

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.

• The practice’s uptake for the cervical screening programme was 73%, which was comparable to the CCG average of 78% and the national average of 74%.

• 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 January 2017

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Patients over 75’s were informed of their named GP.

• The practice had a risk register of those most vulnerable and at risk of hospital admission.

• The practice had a dedicated telephone line for nursing homes or accident and emergency to contact them as required.

Updated 4 January 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.

• 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.

• Sexual health advice, contraception monitoring and chlamydia screening is offered by the practice. All the practice nurses carried out cytology screening.

• The practice participated in an electronic prescribing service.

• The practice offered extended hours appointments on alternate Monday evenings and alternative Saturday mornings.

• The practice held a nurse led open access clinic from 8.30am until 10am each weekday morning which provided a minor illness service for patients.

Updated 4 January 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 higher than the national average of 93%. (Exception reporting rate was 17%).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 4 January 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 homeless people, travellers and those with a learning disability.

• The practice offered longer appointments 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.