Medina Healthcare

Updated 24 January 2017

Medina Healthcare is located at 16 West Street, Newport, Isle of Wight, PO30 1PR, which is close to the centre of Newport. Medina Healthcare is part of the Isle of Wight Clinical Commissioning Group (CCG). The practice operates from premises which are leased by the GP partners. The practice building has four consulting rooms and three treatment rooms.

Medina Healthcare has a branch at Wootton Bridge, Ryde PO33 4NW which is approximately five miles away. The new premises at Wootton Bridge were opened in November 2014. Together the two branches provide care and treatment to 9,000 patients across the two sites. Approximately 5000 patients are registered at West Street and 4000 at Wootton Bridge. All patients have access to appointments at both locations. As part of this inspection we did not visit the branch surgery at Wootton Bridge.

The practice has two male and four female GP partners and a long term locum GP. The GPs in total provide the equivalent of 4.5 full time GPs. Further clinical support is provided by a nurse practitioner, a lead nurse, three further practice nurses and two healthcare assistants. The practice is further supported by a practice manager, reception and administrative staff. The practice has a personal medical services (PMS) contract with NHS England. (This is a locally agreed alternative to the standard General Medical Services contract. This is used when services are agreed locally with a practice which may include additional services beyond the standard contract.)

At the time of the 13 December 2016 visit, the practice had closed its patient list with the permission of NHS England and the Isle of Wight clinical commissioning group. This was because two of the GP partners had been on long term sick leave and the practice had several members of support staff leave.

The practice is open on Monday to Friday between 08.00 and 18.30. There is late opening on a Monday until 19.00 and the practice opens at 07.20 on a Thursday morning. The practice opens on a Saturday morning to treat patients who have pre-booked appointments only.

The Care Quality Commission draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality and Outcomes Framework and the National Patient Survey. This data showed the practice provides care and treatment to a higher than average number of patients who are over the age of 65 which includes care and treatment to people who are living in a large nursing home and two care homes. GP’s from the practice form part of an out of hour’s service for which the CCG are responsible. This service is accessed by patients through the 111 service.

Updated 24 January 2017

Letter from the Chief Inspector of General Practice

We carried out a focused inspection of Medina Healthcare on 13 December 2016 to check that action had been taken since our previous inspection in March 2015.

Overall the practice was rated as good. At our previous inspection, the practice was rated good for Effective, Caring, Responsive and Well Led services.

However, the practice was rated as requires improvement in the Safe domain due to breaches of regulations relating to the safe delivery of services.

At our previous inspection, we found that the practice had not ensured that procedures for the management of infection control included; an annual infection control statement, a completed audit of the premises and a risk assessment and policy for the management of Legionella. Also there was no system in place to monitor the cleaning of carpets and privacy curtains.

We inspected the practice on 13 December 2016 to check that they had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection of Medina Healthcare on our website at www.cqc.org.uk

Our key findings for this inspection were as follows:

• Curtains had been replaced or regularly cleaned in all treatment and consultation rooms.
• Carpets had been steam cleaned bi-annually.
• A Legionella risk assessment had taken place on 31st July 2015 and all actions completed.
• An infection control audit had been undertaken and a training programme for new and existing staff had been instigated.

The practice is now rated good for Safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 June 2015

The practice is rated as good for the care of people with long term conditions. The practice was aware of those patients with long term conditions and had processes in place to make urgent referrals to secondary care should it be necessary or when longer appointments or home visits were needed. All these patients had structured annual reviews to check their health and medication needs were being met.

The practice maintained good communication with community and specialist services where appropriate, for support in the management of patients with long term conditions.

Practice nurses provided home visits for patients who needed regular blood samples for the monitoring of their anticoagulant (blood thinning) medicine.

Updated 18 June 2015

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

The practice held monthly meetings with health visitors to discuss any child safeguarding issues. The practice followed up any non-attendance for routine child immunisations and for paediatric outpatient hospital appointments.

Pre-bookable, same day and emergency appointments were available outside school hours. Sick children were prioritised for same day emergency appointments.

Updated 18 June 2015

The practice is rated good for the care of older people. The practice was successful in a bid to be part of an over 75 years project in two of the nursing homes they visit. This involved bi annual care plan reviews of all residents and GPs and practice chronic disease management nurses offered educational sessions to care home staff.

The practice held multi-disciplinary palliative care meetings each month to discuss the health and social care needs of patients with complex medical needs and those at end of life.

The practice supported the hospital rehabilitation team for up to 20 patients in two homes to enable early discharge from hospital. This was provided through a weekly round and responding to acute need. Regular visits to these homes had improved communication and efficiency.

Updated 18 June 2015

The practice is rated good for the care of working age patients and those recently retired. Appointments were available on Saturday mornings, early Thursday mornings and late Monday evenings for those patients who could not attend during normal working hours. Appointments were regularly monitored and emergency access altered according to demand. The practice encouraged the use of telephone call backs and the use of online ordering for prescriptions.

The practice offered well woman and well man NHS health checks and for those patients in the 40 to 70 year old age range.

There was a virtual patient participation group to capture feedback and suggestions from those patients who may find attending the patient participation group difficult due to other commitments.

Updated 18 June 2015

The practice is rated good for patients experiencing poor mental health (including dementia). The practice had a high prevalence of patients diagnosed with dementia and was actively screening at risk patient groups for signs of dementia. The practice had developed a template for their clinical system. This template contained a six item cognitive test to help with the opportunistic dementia testing of these patients.

Patients with major mental illness were invited for annual health checks during which cardiac risk factors were assessed.

The practice hosted a counsellor from the primary care mental health team. This gave patients easy access to this self-referral service. The GPs and counsellor worked together to support patients with poor mental health.

GPs at the practice have experience in Mental Health Act assessments and all GPs and nurses had recently completed in house training on the Mental Capacity Act 2005.

Updated 18 June 2015

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

One of the GP partners worked with the Isle of Wight drug and alcohol service. They were able to provide additional knowledge and advice for their colleagues to support the complex needs of patients with addictions.

The practice provided care to approximately 30 patients who were homeless and saw them as temporary residents if a medical or social need was identified.

The practice kept a record of patients who had a learning disability; these patients were known to reception staff and had priority access to the GPs. All patients with a learning disability were offered an annual health check.