Archived: Balderton Primary Care Centre

Updated 22 October 2018

Balderton Primary Care Centre provides primary care medical services to approximately 5500 patients via an alternative provider medical services (APMS) contract commissioned by NHS England, and Newark and Sherwood clinical commissioning group.

The regulated activities take place at Balderton Primary Care Centre, Lowfield lane, Balderton, Newark NG24 3HJ. The practice operates from a purpose built premise shared with other health services. All patient services are provided on the ground floor of the building.

The practice opens from 8am to 6.30pm Monday to Friday. Consulting times are generally from 8.30am to 12.30am each morning and from 3pm to 6pm each afternoon. Extended hours appointments are offered on Tuesday evenings and on Friday mornings with a nursing assistant and practice nurse.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by NEMS and is accessed via 111.

Updated 22 October 2018

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 27 September 2017

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

• Clinical staff had lead roles in chronic disease management.

• The practice had a system in place to recall patients for a structured annual review to check their health and medicines needs were being met. Patients with multiple conditions were usually reviewed in one appointment to ensure a holistic view of their care and treatment.

• The GPs worked with a wide range of health and social care professionals to deliver a multi-disciplinary package of care for patients with complex health needs.

• Joint working took place with a diabetic specialist nurse to facilitate the management of complex patients.

• Patients at risk of hospital admission were identified as a priority and systems were in place to follow-up patients discharged from hospital. Care plans were updated to reflect any additional needs.

• Published data showed the practice’s performance for long-term conditions was above or in line with local and national averages. For example, the practice achieved 98.5% for diabetes related indicators. This was above the local average of 95.5% and the national average of 89.9%.

• Longer appointment times and home visits were provided for patients unable to attend the surgery.

Updated 27 September 2017

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

• Staff we spoke with demonstrated they were committed to safeguarding children and young people.

• The lead GP held regular meetings with the health visitors and school nurses to review patients at risk of abuse and / or deteriorating health.

• The practice had emergency processes for acutely ill children and young people.

• Staff told us children aged five years and under were prioritised and seen on the same day. Appointments were also available outside of school hours.

• Reception staff sent a congratulatory card to parents on the birth of new babies.

• The practice provided eight-week baby checks and postnatal reviews.

• Immunisation rates were relatively high for all standard childhood immunisations.

• The practice had baby changing facilities and offered a designated private area for mothers who wished to breastfeed on site.

Updated 27 September 2017

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

• Patients aged 75 years and over had a named accountable GP to ensure they received co-ordinated care.

• The health needs and care plans of frail patients and those at risk of hospital admission were regularly reviewed at the monthly multi-disciplinary meetings.

• Records reviewed and patient feedback showed older people were involved in planning and making decisions about their care, including their end of life care.

• Nationally reported data showed patient outcomes for conditions commonly found in older people were in line with local and national averages.

• Influenza, pneumococcal and shingles vaccinations were offered in accordance with national guidance.

• The practice offered home visits and urgent appointments for patients with enhanced needs. Feedback from one of the care homes showed the practice was responsive to the health needs of patients.

Updated 27 September 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• A range of services were offered at the practice to facilitate the delivery of care closer to home. This included phlebotomy, minor surgery and joint injections.

• The practice was proactive in offering online services including appointment booking, requests for repeat prescriptions and access to some patient records.

• Working age people had access to telephone consultations and advice.

• A range of health promotion and screening services that were relevant to the needs of this age group were promoted. This included NHS health checks, access to a smoking cessation clinic and family planning.

• The uptake rates for cervical cancer screening, bowel and breast cancer screening were generally in line with local and national averages.

• The practice provided extended hours consultations with the nursing assistant and practice nurse on Tuesdays from 6.30pm to 8pm and on Friday from 7am to 8pm.

Updated 27 September 2017

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

• Staff we spoke with had a good understanding of how to support patients with mental health needs and dementia. This included advance care planning for patients living with dementia and assessing a patient’s mental capacity for specific decisions.

• The practice regularly worked with multi-disciplinary teams in the case management of patients within this population group.

• The physical health needs of patients with poor mental health and dementia were reviewed to ensure a holistic assessment of their needs.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had systems in place for monitoring repeat prescribing for patients receiving medicines for mental health needs and to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

Published data showed:

• 91.2% of patients diagnosed with dementia had their care reviewed in a face-to-face meeting in the last 12 months, which was above the local average of 86.5% and the national average of 83.8%.

• All patients with a mental health condition had a documented care plan in the last 12 months, which was above the CCG average of 89.4% and the national average of 88.8%.

To note is the above data relates to the practice’s performance in 2015/16 prior to changes in the provider. The 2016/17 data was yet to be published at the time of our inspection.

Updated 27 September 2017

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

• Staff we spoke with knew how to recognise signs of abuse in vulnerable adults. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies. Safeguarding concerns were regularly discussed at the multi-disciplinary meetings.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients and informed patients how to access various support groups and voluntary organisations.

• End of life care was delivered in a coordinated way. Patients with end-of-life care needs were reviewed at regular multi-disciplinary team meetings attended by the lead GP, district nurses and a palliative community nurse specialist for example.

• The practice had identified 3.6% of their patient list as carers and offered support including annual flu vaccinations.

• The practice offered longer appointments for patients with a learning disability. Ten out of 16 patients with a learning disability had received an annual health review in the last 12 months.

• Clinical staff undertook home visits for patients who were housebound.

• Translation services were provided where required.