Dovercourt Group Practice

Updated 30 March 2016

Dovercourt Surgery is located in a purpose built health centre in inner city Sheffield and accepts patients from Manor, Castle, Norfolk Park and Arbourthorne. The practice catchment area is classed as within the group of the first most deprived areas in England.

The practice provides Primary Medical Services (PMS) under a contract with NHS England for 4,390 patients in the NHS Sheffield Clinical Comissioning Group (CCG) area. It also offers a range of enhanced services such as childhood vaccination and immunisations.

Dovercourt Surgery has one female GP partner and a business partner, eight part time salaried GPs (six female and two male), two nurse practitioners, practice nurse, two healthcare assistants, practice manager and an experienced team of reception and administration staff. The practice is a training practice for medical students.

The practice is open 7am to 6pm Monday to Friday with the exception of Thursdays when the practice closes at 4pm. Extended hours are offered 7.30am to 8am Monday to Friday. Appointments are offered daily between 8.30am and 10am Monday to Friday. This is a walk in surgery where patients can attend without an appointment and be seen by a doctor or nurse practitioner. Pre-bookable appointments are available 11.30am to 12.30 noon Monday and Thursdays, and 7am to 9am Tuesday and Wednesdays. Afternoon clinics are 3.30pm to 5.30pm Monday to Friday with the exception of Thursday when the clinic is 2pm to 4pm.

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 - 8.30am and 6.00pm - 6.30pm. Patients are informed of this when they telephone the practice number.

The practice is registered to provide the following regulated activities; treatment of disease, disorder or injury, diagnostic and screening procedures, maternity and midwifery services and family planning.

Updated 30 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dovercourt Surgery on 2 February 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 the skills, knowledge, training and experience to deliver effective care and treatment with the exception of two members of staff who had not received safeguarding training.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice was performing higher than the national average in several areas including mental health and dementia. For example, 96% of patients diagnosed with dementia had received a face to face meeting in the previous 12 months (compared to the national average of 84%) and of those patients diagnosed with a mental health condition, 98% had a comprehensive care plan reviewed in the last 12 months (compared to the national average of 88%). 
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with urgent appointments available the same day at the walk in clinic.
• 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 areas of outstanding practice:

• The practice offered work placements for people to help develop their confidence, life and work skills. They provided us with examples where this led to permanent employment and support to access further/higher education.

• Staff told us they would act as patient advocates. For example, by helping to write letters and facilitating appointments at the practice instead of in the community so patients could be seen in familiar surroundings.

• The practice had an older people’s co-ordinator who sent screening letters to patients aged over 75 who had not attended the practice for sometime. This was a simple checklist to update on health and general wellbeing. It also provided the practice with regular updated information on carer/next of kin information. The co-ordinator followed an algorithm which enabled the patient to be signposted to other services if appropriate. For example, to the community support worker.

The areas where the provider should make improvements are:

• Maintain a complete record of the immunity status of all clinical staff.

• Maintain a schedule of carpet deep cleaning.

• Ensure all staff complete required safeguarding training as per Safeguarding Children and Young people: roles and competencies for health care staff intercollegiate document (third edition: March 2014).

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 30 March 2016

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

• Nursing staff had lead roles in chronic disease 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 health care trainer to support health promotion.

• 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 30 March 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 similar to other practices in the local CCG area for all standard childhood immunisations.

• Data showed 84% of patients diagnosed with asthma had received an asthma review in the previous 12 months compared 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.

• We saw notices in the patient toilets on how to access help and advice on sensitive issues, for example, domestic abuse.

• The practice hosted parenting classes for patients of the practice and the local community.

• Data showed 93% of women eligible for a cervical screening test had received one in the previous five years compared to the national average of 81%.

• 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 30 March 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 had an older people’s co-ordinator who sent screening letters to patients aged over 75 who had not attended the practice for sometime. This enabled regular updates of personal information, for example, carer/next of kin to be added to the patient's medical record. The co-ordinator followed an algorithm which enabled the patient to be signposted to the relevant services if appropriate. For example, a GP appointment or to the Community Support Worker.

• The practice provided medical care and weekly routine visits to patients who resided in a local intermediate care orthogeriatric unit.

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

Updated 30 March 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 early morning GP and nurse appointments daily from 7.30am and offered evening and weekend appointments through the Sheffield satellite clinic scheme.

• The practice offered appointments at the practice with an occupational health adviser and 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.

• The practice offered short term work placements to sixth form students who required experience to be able to apply for training in the medical profession.

Updated 30 March 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, 96% had had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.

• Of those patients diagnosed with a mental health condition, 98% had a comprehensive care plan reviewed in the last 12 months, which is above the national average of 88%.

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

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

• The practice had told 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 dementia. Reception staff had also received training in dementia awareness.

• The practice had a mental health worker providing more long term support and also hosted Improving Access to Psychological Therapies Programme (IAPT) to support patients’ needs.

Updated 30 March 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 homeless people and those with a learning disability. There was a flagging alert system on the computer to alert staff to patients whose circumstances may make them vulnerable.

• Staff told us they would try to be flexible and book appointments to suit the needs of patients and would send a letter to all patients who did not attend hospital or screening appointments.

• The practice offered longer appointments for patients with a learning disability and used clinical 'props' appropriate for the needs of this group, for example as an aid to teach testicular self examination.

• The practice regularly worked with multidisciplinary teams in the case management of vulnerable people and staff told us they would act as patient advocates. For example, by helping them write letters and facilitating appointments at the practice instead of in the community so patients could be seen in familiar surroundings.

• The GP told us the practice offered work placements for people to help develop their confidence, life and work skills. They provided us with examples where this led to permanent employment and support to access further/higher education.

• The practice informed patients about how to access various support groups and voluntary organisations. For example, to an advocacy worker who would assist and give extra support to patients who needed it.

• The practice actively supported local community initatives to improve the lives of its patients. For example, they assisted with a local foodbank scheme.

• Staff knew how to recognise signs of abuse in 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.