Mosborough Health Centre

Updated 22 November 2016

Mosborough Health Centre is located in a purpose built health centre and accepts patients from Mosborough and the surrounding area. Public Health England data shows the practice population is mostly white british and has a higher than average number of patients aged 45 years and older compared to the England average. The practice catchment area has been identified as one of the seventh least deprived areas nationally.

The practice provides Primary Medical Services (PMS) under a contract with NHS England for 6468 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as anticoagulation monitoring and childhood vaccination and immunisations.

Mosborough Health Centre has five GP partners (four female, one male), one female nurse practitioner, one male physician associate, one female practice nurse, two healthcare assistants, one practice employed pharmacist, a business manager, a practice manager, and an experienced team of reception and administration staff. The practice is a teaching and training practice for GP registrars, medical students, physician associates and nurse students.

The practice is open 8.30am to 6pm Monday to Friday with the exception of Thursdays when the practice closes at 1pm. The Sheffield GP Collaborative provides cover when the practice is closed on a Thursday afternoon. Extended hours are offered on a Wednesday evening until 8pm. Morning and afternoon appointments are offered daily Monday to Friday with the exception of Thursday afternoon when there are no afternoon appointments.

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. The Sheffield GP Collaborative provides cover when the practice is closed between 8am and 6.30pm. For example, at lunchtime. Patients are informed of this when they telephone the practice number.

Updated 22 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mosborough Health Centre on 28 September 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed with the exception of the process for administering medicines under patient specific directions for healthcare assistant staff.
• 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.
• Feedback from patients about their care was consistently positive . They 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 with a named GP 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 one area of outstanding practice:

• The practice had been innovative when reviewing its workforce and had developed the practice skill mix by employing their own pharmacist who supported patients and staff at the practice through review of medicines prescribed, promoting best practice and providing advice for prescribing. They had also recruited a physician associate who was able to deal with minor illness, long term conditions and mental illness freeing up GP time for more complex patient needs.

The areas where the provider should make improvement are:

• Review the process for administering medicines under patient specific directions to ensure they are correctly authorised by an appropriate prescriber.

• Ensure staff who perform chaperone duties follow the practice’s own chaperone policy with regards to recording the event.

• Review the system for checking consumables are within their expiry date throughout the practice.

• Review Public Health England guidance with regard to the use of two thermometers for monitoring of medical fridge temperatures.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 22 November 2016

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

• Nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.

• Longer appointments and home visits were available when needed.

• The practice hosted a pain trainer who helped manage patients with chronic pain problems.

• 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 22 November 2016

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.

• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Data showed 82% of women eligible for a cervical screening test had received one in the previous five years which was comparable to the national average of 82%.

• 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 22 November 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice provided medical care and weekly routine GP visits to patients who resided in two local care homes.

• The percentage of patients aged 65 or over who received a seasonal flu vaccination was 79%, higher than the national average of 73%.

Updated 22 November 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.

• The practice offered evening appointments one evening a week at the practice and weekend and evening appointments at a local practice through the Sheffield satellite clinical scheme.

• The practice hosted an occupational health advisor who was able to support and advise patients on work related problems.

• 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.

Updated 22 November 2016

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

• Of those patients diagnosed with dementia, 89% had received a face to face review of their care in the last 12 months, which is higher than the national average of 84%.

• Of those patients diagnosed with a mental health condition, 94% had a comprehensive care plan reviewed in the last 12 months, which is higher than the national average of 88%.

• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had advised patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• 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 those living with dementia.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT), a counselling service to support patients’ needs.

Updated 22 November 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 had a system to offer flexible appointments to patients from a local travelling community.

• 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.

• The practice hosted a community support worker who would advise and signpost patients to services. For example, information on housing and social care or support to join local social activities.

• 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.