Penwortham St. Marys Medical Group

Updated 16 January 2017

Penworthan St Marys Medical Group is situated in Penworthan near Preston their branch surgery is situated on the Preston City Centre University of Central Lancashire (UCLAN) campus. There were approximately 16855 patients on the practice register at the time of our inspection. The practice population was predominantly students and working age patients.

The practice is managed by two GP partners (male), five salaried GPs (four female and one male), four nurse practitioners and four practice nurses. Members of clinical staff are supported by a practice manager, deputy practice manager, reception and administration staff.

The practice is open between 8am and 6pm Monday to Friday. Appointments are from 8am to12pm every morning and 2pm to 5.30pm daily. Extended hours appointments are offered Saturday and Sunday 8am to 1.30pm.Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service by calling 111.

The practice has a Personal Medical Services (PMS) contract and has enhanced services contracts which include childhood vaccinations. The practice is part of NHS Greater Preston local Clinical Commissioning Group (CCG).

Updated 16 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Penworthan St Marys Medical Group on 17 November 2016.

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 a system in place for reporting and recording significant events. We discussed with the practice the need to review some of the systems and processes that governed risks such complaints and safeguarding.
• 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 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.

We saw several areas of outstanding practice including:

• The practice had a branch surgery based at a University of Central Lancashire (UCLAN) campus and provided services tailored to their student patients. This included providing specialist clinics such as sexual health, travel health and contraception.

• The practice worked closely with the University to ensure the physical and mental health of student patients was promoted and safeguarded. The practice met monthly with all interested stakeholders and participated in health awareness campaigns such as meningitis awareness and smoking cessation run by the University and the Student Union.

• The practice offered a clinic on a Saturday and Sunday 8am to 1.30pm for working patients who could not attend during normal opening hours.

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

The provider should:

• Review the changes made to the safeguarding systems to ensure they are embedded and being used effectively.

• Review the changes made to the complaints processes to ensure they are embedded and verbal complaint information is being appropriately actioned.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 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. For example, patients with chronic obstructive pulmonary disease (COPD) and diabetes.

• 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 multidisciplinary package of care.

Updated 16 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.

• 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, and health visitors.

Updated 16 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.

• The practice had a designated healthcare assistant who carried out home visits for older patients unable to attend the practice to ensure any long term conditions were monitored.

Updated 16 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 opened seven days a week to meet the needs of their patients.

• 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 has a branch surgery based on a University of Central Lancashire (UCLAN) campus and provided services tailored to their student patients. This included specialist clinics such as sexual health, travel health and contraception.

• The practice worked closely with the University to ensure the physical and mental health of student patients was promoted and safeguarded. The practice monthly with all interested stakeholders and participated in health awareness campaigns such as meningitis awareness and smoking cessation run by the University and the Student Union.

Updated 16 January 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 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 worked closely with the University with regard to suicide prevention strategies and engagement.

• 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 16 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 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.