Derwent Medical Centre

Updated 11 November 2016

Derwent Medical Centre provides primary medical services to approximately 4000 patients through a general medical services contract (GMS).

The practice opened in October 1990 and occupies converted residential premises. It is located on North Street, close to the centre of Derby. There is adequate parking available and the practice is accessible by public transport.

The level of deprivation within the practice population is slightly above the national average. Levels of income deprivation affecting children and older people are above the national average. The practice has below average numbers of patients who are over 70 and below 20. There are higher than average numbers of patients aged 25 to 34. In addition there are above average numbers of male patients between the ages of 25 and 60.

The clinical team comprises two GP partners (one male and one female) and two practice nurses (female). The clinical team is supported by a practice manager and a team of reception and administrative staff.

The practice opens from 8am to 6.30pm Monday to Friday. Generally appointments are from 9am to 11.30am each morning and from 4pm to 6pm each afternoon. Extended hours appointments are offered on Tuesday evenings until 7.30pm. In addition to pre-bookable appointments that can be booked up to two months in advance, urgent appointments are available on the day for people that require them.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Derbyshire Health United (DHU).  

Updated 11 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Derwent Medical Centre on 15 September 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had systems in place to enable staff to effectively report and record significant events. Learning from significant events was shared internally and externally.
• Risks to patients were assessed and managed. The practice had a range of risk assessments in place which were regularly reviewed and updated.
• Staff delivered care and treatment in line with evidence based guidance and local guidelines. Training had been provided for staff to ensure they had the skills and knowledge required to deliver effective care and treatment for patients.
• Feedback from patients we spoke with and from comments cards was entirely positive about the care received by the practice. Patients said they were treated with kindness, dignity and respect and were involved in decisions about their care.
• Information about services and how to complain was available and easy to understand. Complaints were dealt with promptly.
• Patients were very positive about their access to care and treatment. Patients generally found it easy to make appointments with urgent appointments available on the day. Routine appointments were generally available to see a GP within two working days.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Adjustments had been made to the premises to ensure they were suitable for patients with a disability.
• There was a clear leadership structure which all staff were aware of. Staff told us they felt supported by the GPs and the practice manager. The practice proactively sought feedback from staff and patients, which it acted on.
• The practice was working closely with their patient participation group (PPG) to develop their role and identify areas for improvement. The practice was responsive to suggestions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 November 2016

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

• Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was 94.6% which was 1.5% above the CCG average and 5.4% above the national average. The exception reporting rate for diabetes indicators was 11.6% which in line with the CCG average of 13.4% and the national average of 10.8%.
• Performance for indicators related to hypertension was 100% which was 1.4% above the CCG average and 2.2% above the national average. The exception reporting rate for hypertension related indicators was 0.9% which was below the CCG average of 4.1% and the national average of 3.8%.
• Effective recalls systems were in place within the practice and patients with more than one long-term condition were invited to a single appointment.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and were offered a structured annual review to check their health and medicines needs were being met.
• For patients with the most complex needs, the named GP worked with the care coordinator and relevant health and social care professionals to deliver a multidisciplinary package of care.

Updated 11 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.
• 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day access to appointments was offered for all children and there was a lower than average attendance of children at A&E.
• We saw positive examples of joint working with community staff to ensure children at risk of harm were kept safe.

Updated 11 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.
• All patients over 75 years had a named GP.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• A range of vaccinations were offered to older patients including shingles and flu vaccinations.
• A care coordinator who was assigned to the practice worked from the practice one day per week to ensure the needs of older patients were being met.

Updated 11 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.
• Extended hours appointments were offered with a GP and nurse to facilitate access for working age patients.
• A range of online services were available including appointment booking and the ordering of repeat prescriptions. The practice had a presence on social media websites and used this to communicate with patients.
• 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. The practice had identified that their cancer screening rates were below national averages and were seeking to improve patient education and uptake.
• A range of contraceptive services were offered within the practice.

Updated 11 November 2016

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

• Performance for mental health related indicators was 99.4% which was 2.5% above the CCG average and 6.6% above the national average. The exception reporting rate for mental health related indicators was 7.1% which was below the CCG average of 16.9% and the national average of 11.1%.
• 85.7% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was 0.3% above the CCG average and 1.7% above the national average. The exception reporting rate for this indicator was 0% which was below the CCG average of 9.2% and the national average of 8.3%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Systems were 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. A number of staff within the practice had completed dementia awareness training.

Updated 11 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.
• Longer appointments were offered for patients with a learning disability and for those who required them.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• Vulnerable patients were informed about how to access local and national 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.
• The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 66 patients as carers (1.7% of the practice list).