Archived: Melbourne Street Surgery

Updated 21 May 2015

Johnson Medical Practice is also known as Melbourne Street Surgery and is in the Highfield’s area of Leicester. The practice has approximately 2,500 patients. The practice is located in non-purpose built premises. The practice has a higher percentage of younger patients aged between 25 to 39 years. The patient group is made up of black minority ethnic (BME) 62% compared to the local clinical commissioning group (CCG) data of 49%. The range of services provided includes minor surgery, minor injuries, maternity care, blood testing, vaccinations, mental health, drug and alcohol services and various clinics for patients with long term conditions.

The practice employs three GP partners, two salaried GPs (one of whom is in the process of becoming a partner) and two long term GP locums. The practice provides 48 clinical GP sessions weekly at both practices. The practice is in the process of recruiting two nurses. There are one locum nurse, two health care assistants, a phlebotomist and a practice pharmacist. There are seven administrative and IT staff, one complaints manager, one practice manager and a full time medical secretary. The practice is a training practice for doctors in training and takes on Registrars and medical students. A registrar is a fully qualified doctor working in the surgery to develop their skills in general practice.

Johnson Medical Practice has two practices, Melbourne Street Surgery and Hilltop Surgery were visited on the same day and the policies, process, staff and systems were shared across two sites.

The practice opted out of providing the out-of-hours service. This service is provided by the out-of-hours NHS 111 service. The practice holds a GMS (General Medical Services) to deliver essential primary care services.

The practice works within Leicester City CCG (Clinical Commissioning Group). A CCG is an NHS organisation that brings together GPs and health professionals to take on commissioning responsibilities for local health services.

Updated 21 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Melbourne Street Surgery on 14 November 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people who circumstances may make them vulnerable, and people experiencing poor mental health.

Our key findings were as follows:

• Systems were in place to ensure the environment and equipment were clean and staff followed hygienic procedures to minimise the risk of infection.
• The practice worked in partnership with midwives, health visitors and school nurses to share information, concerns, and best ways to support families.
• Patients described the staff as friendly and caring, and said that they felt that they treated them with respect and dignity.
• Patients were involved in decisions about their health and treatment, and received support to cope emotionally with their care and condition
• There was good teamwork, leadership, and commitment to improving the quality of care and patients experiences.

However there were areas of practice where the provider should make improvements.

The provider should:

• Update arrangements processes and systems to ensure that emergency drugs and equipment are available for the doctor’s bags.
• Ensure the safeguarding adult’s policies and procedures and the whistleblowing policy are up to date and in line with internal reporting procedures. The whistleblowing policy should include contact organisations and current guidance on how to raise concerns at work.
• Ensure that staff have the necessary knowledge and understanding in relation to the Mental Capacity Act 2005 to apply the principles of the Act when necessary.
• The practice should review their arrangements for recruitment to ensure that appropriate risks assessments and checks are completed when necessary.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 May 2015

The practice is rated as good for the population group of people with long term conditions. All patients were offered an annual review including a review of their medication, to check that their health needs were being met. When needed longer appointments and home visits were available. Where possible, clinicians reviewed patients’ long term conditions and any other needs at one time, to prevent them from attending various appointments. Emergency processes were in place and referrals were made for patients that had a sudden deterioration in their health. For those people with the most complex needs, a named GP worked with relevant health and care professionals to deliver multidisciplinary support and care.

Updated 21 May 2015

The practice is rated as good for the population group of families, children and young people. Systems were in place for identifying and following-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 safeguarding lead regularly met with the health visitor to discuss looked after children, unborn babies and mothers, and children on the safeguarding register to share information, concerns, and best ways to support families. Immunisation rates were high for all standard childhood immunisations. The practice worked in partnership with midwives, health visitors and school nurses. Appointments were available outside of school hours to enable children to attend. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health.

The practice promoted good health within its younger population group. Examples included offering a confidential service to young people by providing full sexual health screening and the availability of private facilities for self-testing for chlamydia for young people between 16-24 years.

Updated 21 May 2015

The practice is rated as good for the care of older people. Patients 65 years and over were offered an annual health check. All patients 75 years and over were allocated a named GP to offer continuity of care to ensure that their needs were being met. Health care plans were provided for patients over 75 years, to help avoid unplanned admissions to hospital. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example in dementia and end of life care. The practice was responsive to the needs of older people, including offering home visits for elderly housebound patients.

Updated 21 May 2015

The practice is rated as good for the population group of the working-age people (including those recently retired and students). The practice provided extended opening hours to enable patients to attend in early morning or in the evening. Patients were also offered telephone consultations and were able to book non-urgent appointments around their working day by telephone, and on line. The practice offered a choose and book service for patients referred to secondary services, which enabled them greater flexibility over when and where their appointments and tests took place. NHS health checks were offered to patients over 40 years. The practice offered health promotion and screening appropriate to the needs for this age group.

Updated 21 May 2015

Staff had received training on how to care for people with mental health needs and dementia. The practice held a register of patients experiencing poor mental health. Patients were offered an annual health check review including a review of their medicines by the practice pharmacist to ensure that medicines were prescribed appropriately and safely. A mental health worker and counsellor held regular clinics at the practice to support patients. This was a community service. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, to ensure their needs were regularly reviewed, and that appropriate risk assessments and care plans were in place. Patients were supported to access emergency care and treatment when experiencing a mental health crisis.

Updated 21 May 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including people with learning disabilities. Patients with a learning disability were offered an annual health review, including a review of their medication. When needed longer appointments and home visits were available. The practice worked with multi-disciplinary teams in the case management of people in vulnerable circumstances and at risk of abuse. Carers of vulnerable patients were identified and offered support. Alcohol and drug misuse services were available to patients and were a community service. A smoking cessation service was also available.