The Abbey Medical Group Also known as Blidworth Surgery

Updated 23 March 2016

The Abbey Medical Group provides primary medical services to approximately 11777 patients through a personal medical services contract (PMS). Services are provided to patients from two surgeries based at Blidworth and Ravenshead. Blidworth is a former mining community and Ravenshead has a primarily agricultural history.

The level of deprivation within the practice population is below the national average. Income deprivation affecting children and older people is also below the national average.

The clinical team comprises seven GP partners, two nurse practitioners, two practice nurses, two healthcare assistants and a phlebotomist. The clinical team is supported by a practice manager, an assistant practice manager, two reception managers and a range of IT, reception and administrative staff.

The practice opens from 8am to 6.30pm on Monday to Friday. The practice closes on the second Wednesday of every month for the afternoon to facilitate staff training. A range of appointments are available depending on the day of the week. These start from between 7.30am and 8am to 11.15am each morning and from between 2pm and 2.30pm to 6pm each afternoon. The practice does not close for lunch. Extended hours appointments are available three to four mornings per week from 7.30am. The practice offers occasional Saturday morning opening.

The practice has opted out of providing out-of-hours services to its own patients. This service is provided by Central Nottinghamshire Clinical Services Limited (CNCS).

Updated 23 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Abbey Medical Group on 2 February 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning were identified and mechanisms were in place to share learning effectively.
• 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 and experience to deliver effective care and treatment.
• Feedback from patients about their care was generally positive. Patients told us staff were polite and helpful and treated them with dignity and respect.
• Patients told us they generally found it easy to make an appointment with a GP, with urgent appointments available the same day.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example the practice hosted the Citizen’s Advice Bureau one day per week.
• The practice worked closely with their patient participation group to engage with their patients and the local community. For example, the PPG had facilitated a number of community health education events open to patients of the practice and members of the community.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. The strategy was regularly reviewed and areas for improvement were identified on an ongoing basis.
• 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.

We saw several areas of outstanding practice including:

• The practice had been selected to participate in a community pharmacy pilot project from October 2015. This placed an independent prescribing pharmacist within the practice for three days each week. From 1 October to 31 December the pharmacist had recorded 420 patient contacts. Contacts included medication reviews, nursing home reviews and queries from staff and patients. Feedback from the practice, patients and the project team was positive about the project. The practice benefitted from having medicines expertise on site and there was increased access to GP time for patients.

• There was an effective relationship between the practice and the patient participation group (PPG) which benefitted patients. The PPG facilitated a wide range of events to engage with patients and promote healthier living. For example, the PPG had organised an event in November 2015 which was attended by over 100 people and supported by 24 local organisations. In addition the PPG had built strong links with NHS organisations across the area and arranged events related to carers, men’s health and pain management. These events were open to patients and members of the community.

However there were areas of practice where the provider should make improvements:

• Ensure blank prescriptions are handled securely in line with guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 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. The practice had identified 2.3% of its patients as being at risk of admission.

• The practice offered nurse practitioner led weekly anticoagulation clinics to provide monitoring for patients taking warfarin.

• Indicators to measure the management of diabetes were higher than local and national averages. For example, the percentage of patients on the practice register for diabetes with a record of being referred to a structured education programme within nine months of entry onto the register was 96.2%. This was above the local and national averages and was achieved with a 0% exception reporting rate.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check 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 23 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 relatively high for all standard childhood immunisations.

• The premises were suitable for children and babies. Urgent appointments were always available on the day.

• Fortnightly baby clinics were provided at the practice’s branch surgery.

• One GP and two nurse practitioners provided a service to fit coils and contraceptive implants.

• The practice had run a competition for children in a local school to design a new practice logo.

Updated 23 March 2016

The practice is rated as good for the care of older people.

• 10.6% of the practice population were over the age of 75. The practice offered proactive, personalised care to meet the needs of these patients.

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

• Enhanced services were provided to local care homes with regular visits being conducted by the GPs and GP registrars.

• Medication reviews were undertaken in care homes by the practice based pharmacist.

Updated 23 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.

• Extended hours appointments were offered three to four mornings each week from 7.30am to facilitate access for working age patients.

• Telephone triage and telephone consultations were offered where this was appropriate.

• The practice was proactive in offering online services and all GP appointments were offered through the online booking system

• Health promotion and screening was provided that reflected the needs for this age group.

Updated 23 March 2016

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

• 92.1% of patients with a mental health condition had a comprehensive care plan documented in their records in the previous 12 months which was above the CCG average of 81%.

• 75.5% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months which was 2.9% below the CCG average. However; this was achieved with an exception reporting rate of 4.3% which was 10.1% below the CCG average.

• 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 and all staff had received dementia training in 2015.

• The patient participation group was working to set up a memory group to help patients and carers affected by issues related to dementia.

Updated 23 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 those with a learning disability.

• It offered longer appointments for people with a learning disability in addition to offering other reasonable adjustments.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. In addition vulnerable patients were regularly discussed at the weekly partners’ meetings.

• Information was available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults. Staff were aware of their responsibilities regarding information sharing and documentation of safeguarding concerns.