Archived: Rainworth Health Centre Also known as Rainworth Surgery

Updated 20 August 2015

Rainworth Medical Centre provides primary medical care services to approximately 6,000 patients. The practice is based in a building in the centre of Rainworth village which is approximately three miles to the east of Mansfield in north Nottinghamshire.

The address of the practice is: Warsop Lane, Rainworth, Mansfield, Nottinghamshire NG21 0AD. Information received from Sherwood and Newark Clinical Commissioning Group (CCG) indicated that Rainworth is an area of mixed social deprivation.

The practice provides primary medical services and support to eight local care homes.

An independent pharmacy was located at the practice premises.

The practice has a General Medical Services (GMS) contract with NHS England. This is a contract for the practice to deliver primary care services to the local community or communities.

There are four GPs at the practice, all of whom are partners. There is one male GP and three female GPs. In addition the nursing team comprises one practice nurse and two health care assistants. The clinical team are supported by the practice manager and an administrative team. There are three whole time equivalent GPs working at the practice, in addition there is 0.6 whole time equivalent nurses.

During the evenings and at weekends an out-of-hours service is provided by Central Nottinghamshire Clinical Services (CNCS) which is accessed through the 111 telephone number.

Updated 20 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rainworth Health Centre on 23 February 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice to be good for providing safe, caring and responsive services. It required improvement for providing effective and well led services. The concerns which led to these ratings apply to everyone using the practice, therefore the practice is rated as requires improvement for providing services for older people, people with long term conditions, families, children and young people, working aged people (including those recently retired and students), people whose circumstances make them vulnerable and those people who were experiencing poor mental health (including people with dementia).

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

• Risks to patients were assessed and processes were in place to manage these.
• Patients’ needs were assessed but limited clinical capacity meant the practice needed to improve clinical outcomes for patients. They anticipated this would be addressed when the practice merged. This has taken place since our inspection and the practice is owned by a new provider.
• 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.
• 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.
• There was a clear vision for the future, with plans to develop and improve the service for the benefit of the patients.

However there were areas of practice where the provider needs to make improvements.

The provider should:

• Ensure records of incidents and accidents that have occurred are kept.
• Ensure that staff records demonstrate that all relevant staff are up to date with their Hepatitis B vaccinations, and received a five yearly booster, where required.
• Improve performance against Quality Outcomes Framework (QOF) targets which are below the CCG and national average to ensure effective patient care. (QOF is a voluntary incentive scheme for GP practices in the UK. The scheme financially rewards practices for managing some of the most common long-term conditions and for the implementation of preventative measures).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 August 2015

The provider is rated as requires improvement for the care of people with long term conditions. The practice is rated as good for providing safe, caring and responsive services. The practice is rated as requires improvement for providing effective and well-led services. The concerns which led to these ratings apply to everyone using the service, including this population group.

The practice was located in a former mining area and had a higher than average number of patients with long-term conditions as a result.

GPs 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.

Each patient had a named GP but the QOF data showed that with the exception of atrial fibrillation (0.1% above), diabetes (2.3% above) and people with a learning disability (9% above), the clinical indicators for patients with long term conditions were below the CCG average. In some cases they were significantly lower. For example in respect of patients with osteoporosis (bone fragility) the practice performance was 24.4 percentage points below the CCG Average. (QOF is a voluntary incentive scheme for GP practices in the UK. The scheme financially rewards practices for managing some of the most common long-term conditions and for the implementation of preventative measures).

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. The practice had good links with other health care professionals to provide support to patients with long-term conditions.

Updated 20 August 2015

The provider is rated as requires improvement for the care of families, children and young people. The practice is rated as good for providing safe, caring and responsive services. The practice is rated as requires improvement for providing effective and well-led services. The concerns which led to these ratings apply to everyone using the service, including this population group.

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 in line with the CCG average 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. The premises were suitable for children and babies, with easy access and baby changing facilities available. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 20 August 2015

The provider is rated as requires improvement for the care of older people. The practice is rated as good for providing safe, caring and responsive services. The practice is rated as requires improvement for providing effective and well-led services. The concerns which led to these ratings apply to everyone using the service, including this population group.

The practice offered personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care.

It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice held multi-disciplinary meetings (PRISM) as a way of highlighting patients who were most at risk of hospital admission and planning support and treatment in the community to avoid this happening.

Updated 20 August 2015

The provider is rated as requires improvement for the care of working age people (including those recently retired and students). The practice is rated as good for providing safe, caring and responsive services. The practice is rated as requires improvement for providing effective and well-led services. The concerns which led to these ratings apply to everyone using the service, including this population group.

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 reflects the needs for this age group.

The practice’s performance for cervical smear uptake was 93.5% which was significantly above the CCG and national average. In addition the practice offered chlamydia screening to patients aged 18 to 25 years and offered smoking cessation advice to smokers.

At the time of our inspection there were no additional arrangements to meet the needs of the working population. However, there were plans following changes at the practice to introduce more flexible opening hours, including Saturday morning surgeries from May 2015.

Updated 20 August 2015

The provider is rated as requires improvement for the care of people experiencing poor mental health (including people with dementia). The practice is rated as good for providing safe, caring and responsive services. The practice is rated as requires improvement for providing effective and well-led services. The concerns which led to these ratings apply to everyone using the service, including this population group.

Ninety five percent of people with a diagnosis of dementia had received an annual physical health check during 2013/4 and the practice performance in respect of undertaking face to face reviews was higher than the CCG average on all three QOF indicators. However the practice performance in respect of patients with a diagnosis of depression was 64.2% below the CCG average. (QOF is a voluntary incentive scheme for GP practices in the UK. The scheme financially rewards practices for managing some of the most common long-term conditions and for the implementation of preventative measures).

The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice also had access to an on-site memory clinic for those patients who required it.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 20 August 2015

The provider is rated as requires improvement for the care of people whose circumstances may make them vulnerable. The practice is rated as good for providing safe, caring and responsive services. The practice is rated as requires improvement for providing effective and well-led services. The concerns which led to these ratings apply to everyone using the service, including this population group.

The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks for people with a learning disability and approximately 60% of these patients had received a health check in 2013/14. Plans were in place to provide annual health checks going forward in 2015. The practice also offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.