Archived: Greyfriars Health Centre

Updated 22 January 2015

Greyfriars Health Centre, in the Great Yarmouth and Waveney clinical commissioning group (CCG) area, provides a range of alternative primary medical services to approximately 4500 registered patients living in Great Yarmouth and the surrounding villages. They also provide a GP led health centre (walk in centre) to non-registered patients in Great Yarmouth and the surrounding villages. They see approximately 15000 non-registered patients per year. Greyfriars Health Centre is open from 8:00am to 8:00pm, 365 days a year.

The practice is provided by Malling Health UK Ltd, a limited partnership, based in Kent. Malling Health UK Ltd hold managerial and financial responsibility for the practice. They employ six GPs, (3.2 whole time equivalent) and five nursing staff, (4.45 whole time equivalent). Two of the nurses are nurse practitioners, who have additional education and training and are qualified to treat certain medical conditions without the direct supervision of a doctor. There is also a health care assistant, eight receptionists, two administration staff and a deputy practice manager.

The practice has a higher proportion of patients under 18 and a significantly lower proportion of patients aged over 65 compared with the England average. The proportion of children and older patients, who live in a low income household and are registered with the practice, is significantly higher than the England average. Just under half of the patients at the practice identified themselves as British with the other patients from other ethnic origins.

Greyfriars Health Centre provides services to patients who are on the special allocation scheme. This scheme is for patients who have been removed from other practices list due to behaviour that other practices have deemed unacceptable, for example the threat of verbal or physical abuse. This service is provided three designated mornings a week and the appointments are for thirty minutes.

Outside of practice opening hours a service is provided by another health care provider (South East Health) by patients dialling the national 111 service.

The majority of the patients we spoke with during our inspection, and all of the patients who completed the comments cards, made positive comments about Greyfriars Health Centre and the service they provided. The staff told us that they felt supported.

We examined patient care across the following population groups: older people; those with long term conditions; families, children and young people; working age people (including those recently retired and students); people living in vulnerable circumstances; and people experiencing poor mental health (including people with dementia). We found that care was tailored appropriately to the individual circumstances and needs of most of the patients in these groups. However the practice did not proactively offer a translation/interpreting service to patients, which meant that we could not be assured that their needs were being appropriately met.

Updated 22 January 2015

Letter from the Chief Inspector of General Practice

We visited Greyfriars Health Centre on  6 October 2014 and carried out a comprehensive inspection. We found that the practice provided a good service to patients in all of the five key areas we looked at. This applied to patients across all age ranges and to patients with varied needs due to their health or social circumstances.

The overall rating for this practice is good, with elements of outstanding practice in the care of people living in vulnerable circumstances.

Our key findings were as follows:

• Patients were satisfied with the opening hours and felt they were treated with dignity, care and respect. They were involved in decisions about their care and treatment.
• There were systems in place to provide a safe, effective, caring, responsive and well led service.
• The practice was clean and hygienic and had robust arrangements for reducing the risks from healthcare associated infections.
• The needs of the practice population were understood and services were offered to meet these.

We saw areas of outstanding practice including:

• The practice opened from 8am to 8pm, Sundays and bank holidays, including Christmas day.
• The provision of medical care and health advice to homeless patients, through a weekly clinic at the Salvation Army.
• A weekly clinic for patients who were prescribed addictive medicines, which ran alongside a clinic led by Norfolk alcohol recovery partnership. This resulted in positive outcomes for patients. For example there has been a reduction in the dose of benzodiazepines prescribed to patients who had an addiction to benzodiazepines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 January 2015

This practice is rated as good for the care of patients with long term conditions. The practice supported patients to receive coordinated, multi-disciplinary care whilst retaining oversight of their care. The practice had effective arrangements for making sure that patients with long term conditions were invited to the practice for annual or more frequent reviews depending on their needs. Patients who did not attend were followed up.

Updated 22 January 2015

The practice is rated as good for families, children and young people. The practice was open from 8am until 8pm, 365 days a year, so appointments for school children were available out of school hours. The premises were suitable for children and babies. A midwife came to the practice once a week to see expectant mothers. Antenatal and baby clinic appoints could be made at the patient’s convenience, as there was no set appointment times for these. There was effective liaison between the midwife and the clinical staff at the practice. Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk. The practice provided a family planning service and an emergency contraception service. 

Updated 22 January 2015

The practice is rated as good for the care of older people. Patients over the age of 75 had a named GP who was responsible for the coordination of their care. Home visits were undertaken for patients who were housebound and unable to attend the practice. Care plans had been put in place for elderly patients most at risk of unplanned admissions to hospital and monthly review meetings were held to assess effectiveness.

Updated 22 January 2015

The practice is rated as good for 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 which reflected the needs of this age group. The practice was open from 8am until 8pm, 365 days a year, so appointments were available at a time suitable for working age patients.

Updated 22 January 2015

The practice is rated as good for people experiencing poor mental health (including dementia). The GPs had the necessary skills and information to treat or refer patients with poor mental health. An Improving Access to Psychological Therapy (IAPT) service was provided locally and patients were referred appropriately. The practice arranged the appointments, with the consent of patients who were not able to easily make appointments independently. Extended appointments were standard during a number of clinics provided by the practice.

Updated 22 January 2015

The practice is rated as outstanding for people whose circumstance may make them vulnerable. The practice provided a number of services to meet the needs of patients living in vulnerable circumstances. They provided services to patients who were on the special allocation scheme. This scheme is for patients who have been removed from other practices list due to behaviour that other practices have deemed unacceptable, for example the threat of verbal or physical abuse. The practice worked jointly with Norfolk recovery partnership and provided a weekly clinic for patients who were prescribed addictive medicines.

The practice has worked with the local Salvation Army to provide medical care and health advice to homeless patients. This includes a health care assistant (HCA) attending the Salvation Army weekly to see if any homeless patients need medical care or health advice. If medical care was needed, the HCA arranged for a GP to visit. In addition, medical related correspondence was sent to the Salvation Army with the consent of homeless patient, so that they were able to access this correspondence. This resulted in positive outcomes for patients. For example, patients were accurately registered as homeless and had received a health check.

The practice was accessible for any vulnerable group. There was a booking in touch screen in the reception area with a variety of languages available for patients whose first language was not English. Information was available in a number of languages and we saw examples of letters to patients which were in their language. A telephone interpretation service was available, although this was not always used as it was difficult to plan this when it was needed for non-registered patients. Staff at the practice provided support to patients who were unable to read and/or write to complete registration forms. Extended appointments were standard during a number of clinics provided by the practice.

One of the nursing staff had recently undertaken training to undertake care planning for patients with a learning disability. The practice had a register of patients with a learning disability and they were offered an annual review of their health care needs.