Archived: City Health Care Partnership CIC - Kingston Medical Centre

Updated 8 November 2016

Kingston Medical Centre is situated in the north close to the centre of the City of Hull and provides services under an Alternative Provider Medical Services (APMS) contract with the NHS England, Hull Area Team to the practice population of 7,313, covering patients of all ages.

The practice has four salaried GPs three male and one female, four practice nurses and two health care assistants. There is a practice manager, a central data quality manager and a team of secretarial, administration and reception staff.

The practice is open between 8am and 6.30pm Monday to Friday. Saturday Nurse led appointments are available from 8.30am to 12.30pm. The practice also provides an ‘open access clinic’. This is for patients in need of urgent care that could not wait for a routine appointment. These clinics are open 8am to 11am Monday, Tuesday, Wednesday and Friday. The practice, along with all other practices in the Hull CCG area have a contractual agreement for NHS 111 service to provide Out of Hours (OOHs) services from 6.30pm. This has been agreed with the NHS England area team. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

The proportion of the practice population in the 10-14 years age group is significantly lower than the England average. The practice population in the 55-75 years age group is lower than the England average. The practice also has 38% of its registered list as non-English speaking patients. The practice scored one on the deprivation measurement scale, which is the first lowest deprived. People living in more deprived areas tend to have greater need for health services. The overall practice deprivation score is similar to the England average, the practice is 53.2 and the England average is 21.8.

Updated 8 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingston Medical Centre on 13 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.
• 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.
• Patients 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.

The areas where the provider should make improvements are:

• Ensure infection control audit actions in regards to building work requirements are fully completed in line with infection control national guidelines.

• The system for ensuring all alerts are completed should be acted on.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 November 2016

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

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

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, performance for diabetes related indicators was 87%, which was similar to the CCG and national average.  

• Longer appointments and home visits were available when needed.

• All of these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 8 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.

• Nationally reported data from 2014/2015 showed patients diagnosed with asthma, on the register, who had had an asthma review in the last 12 months was 76%, which was similar to the local CCG average 76% and similar to the national average of 75%.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 88%, which was similar to the local CCG average of 88% and similar to the national average of 88%.  

• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 8 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.

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

Updated 8 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 was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 8 November 2016

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

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record, in the preceding 12 months was 85%. This was similar to the local CCG average of 89% and similar to the national average of 89%.

• Nationally reported data from 2014/2015 showed 86% of people diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was similar to the local CCG average of 86% and similar to the national average of 84%.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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.

• It 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 people with mental health needs and dementia.

Updated 8 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 and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• 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.

• 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.