Gresleydale Healthcare Centre

Updated 29 September 2016

Gresleydale Healthcare Centre provides primary medical services to approximately 10800 patients through a general medical services contract (GMS).

The practice is located in purpose built premises in Swadlincote, Derbyshire. Services are provided to patients from ground floor consulting and treatment rooms. Administrative offices are located on the first floor which is accessible by a lift. The practice has car parking including parking for patients with a disability.

The level of deprivation within the practice population is below the national average with the practice falling into the 7th most deprived decile. The level of deprivation affecting children and older people is below the local and national average. The practice has higher than average numbers of young children and working age patients. Numbers of older people are below average.

The clinical team is comprised of four GP partners (female), one nurse practitioner partner (female), two salaried GPs (female), an advanced nurse practitioner, three practice nurses and two healthcare assistants. The clinical team is supported by a practice manager, a practice development manager and reception and administrative staff. The practice is a teaching practice for medical students and a training practice for trainee doctors.

The surgery is open from 8am to 6.30pm on Monday to Friday. Extended hours were offered on Monday mornings from 7.30am and once a month on Saturdays from 8am to 12pm. Consulting times vary but are usually from 9am to 12pm each morning and 3pm to 5.30pm each afternoon.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United (DHU) and is accessed via 111.

Updated 29 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gresleydale Healthcare Centre on 27 July 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 within the practice. Effective systems were in place to report, record and learn from significant events. Learning was shared with staff and external stakeholders where appropriate.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Outcomes for patients were generally above or in line with local and national averages. For example, the practice performance for cervical screening was above the local and national average.
• Training was provided for staff which equipped 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.
• Patients told us they were able to get an appointment with a GP when they needed one, with urgent appointments available on the same day.
• 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 and learning from complaints was shared with staff and stakeholders.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Services were designed to meet the needs of patients.
• 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 practice had an active patient participation group (PPG) who worked in partnership with the practice team to aid the practice to develop and improve.

We saw several areas of outstanding practice:

• The practice had identified that they had a higher than average number of young children registered with the practice, especially those under five years. In response to falling immunisation uptake figures, the practice set up Gresleydale Tots Clinic. This evolved into a drop in session for babies and parents for peer support, self-weighing and access to immunisation services. The service was run weekly and was supported by the health visiting service. Immunisation uptake for the last quarter showed that the practice achievement for all immunisations ranged from 95% to 100%.
• The practice provided and facilitated a range of services to support patients. These included hosting weekly walking groups and providing chair based exercise classes which were well attended.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 September 2016

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 97.5% which was 4% above the CCG average and 8% above the national average. The exception reporting rate for diabetes indicators was 14% which was in line with the CCG average of 13% and above the national average of 11%.
• Longer appointments and home visits were available when needed.
• 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. The practice worked closely with the community trust employed care coordinator. Feedback from the care coordinator was positive about the level of engagement and commitment to their patients demonstrated by the practice.

Updated 29 September 2016

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 dedicated child safeguarding lead and an administrative lead and staff were aware of who these were.
• 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. The GP lead for safeguarding liaised with other health and care professionals to discuss children at risk.
• Immunisation rates were relatively high for all standard childhood immunisations and the practice worked with health visitors to follow up children who did not attend for immunisations.
• The practice ran a drop in session for babies called Gresleydale Tots Clinic. This enabled parent to access peer support, self-weighing and also provided access to drop-in immunisation services. This service was run by nursing staff and also supported by the health visiting service. Immunisation uptake for the last quarter showed that the practice achievement for all immunisations ranged from 95% to 100%.
• 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.

Updated 29 September 2016

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. Regular multidisciplinary meetings were held to review frail patients and those at risk of hospital admission to plan and deliver care appropriate to their needs. These were facilitated by the care coordinator who worked closely with the practice.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• A designated Advanced Nurse Practitioner visited local care homes and residential homes on a monthly basis 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.

Updated 29 September 2016

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.
• Extended hours services were offered one morning per week and one Saturday morning per month to facilitate access for working 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. Uptake rates for screening were similar or above the national average. For example, the uptake rate for cervical cancer screening was 79% compared with the national average of 74%.

Updated 29 September 2016

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

• The number of people with a mental health condition that had received a comprehensive care plan in the last 12 months was 96%, which was 6% above the local average and 7% above the national average. This was with an exception rate of 14%, which was 7% below the local average and in line with the national average of 13%.
• 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 97% which was 11.6% above the local average and 13% above the national average. This was achieved with an exception reporting rate of 0%.
• 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.

Updated 29 September 2016

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. Annual reviews were undertaken by the healthcare assistant and the nurse practitioner.
• 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 meetings to discuss patients on their palliative care register.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations. The care coordinator worked with vulnerable patients to ensure that they had appropriate health and social care support in place and made referral to other 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.