Archived: Balderton Medical Practice

Updated 23 April 2015

Balderton Medical Practice provides primary medical services to approximately 5,300 patients. The practice is based in Newark in north Nottinghamshire.

Newark is an area of lower social deprivation with good local facilities and amenities.The address where the regulated activities take place is: Balderton Primary Care Centre, Lowfield lane, Balderton, Newark NG24 3HJ.

The practice is managed by Malling Health (UK) Limited, which is an organisation that manages various health services in England.

The clinical team at the practice includes three salaried male GPs, an advanced nurse practitioner, two practice nurses and a health care assistant. The clinical team are supported by the business manager and an administrative team including reception staff.

There are three whole time equivalent GPs working at the practice, in addition there are 2.6 whole time equivalent nursing staff.

The practice holds an Alternative Personalised Medical Services (APMS) contract to deliver essential and enhanced primary care services. The contract means only salaried GPs are employed and there are no partners.

Balderton Medical Practice has opted to take part in the Prime Minister’s challenge winter pilot. This has seen the practice offering same day urgent walk-in appointments on Monday and Friday mornings to help improve access to primary care and alleviate pressures for NHS services. During the evenings and at weekends an out-of-hours service is provided by Central Nottinghamshire Clinical Services (CNCS) Contact is via the NHS 111 telephone number.

Updated 23 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Balderton Medical Practice on 25 February 2015. This is the first time we have inspected this practice.

Overall the practice is rated as good. Specifically, we found the practice to be good for providing well-led, safe, effective, caring and responsive services. It was also rated as good for providing services for all the population groups.

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

• Comments from patients were generally very positive about the care and services they received. They said that they were treated with kindness, dignity and respect and were involved in decisions about their care and treatment.
• The practice was accessible and well equipped to meet patients’ needs.
• Patients had access to care and treatment when they needed it. Patients were usually able to make an urgent appointment or request a telephone consultation the same day. The practice was working to further improve access to non-urgent appointments.
• Procedures were in place to help keep patients safe and to protect them from harm.
• Patients felt listened to and able to raise concerns about the practice. Concerns were acted on to improve the service.
• Staff felt valued and well supported. The practice had a motivated staff team with appropriate knowledge and skills to enable them to carry out their work effectively. Staff were actively supported to acquire new skills to ensure high quality care.
• Systems were in place to assess and monitor the quality and safety of services that people received; although the clinical audit programme required developing to improve outcomes for patients.
• The services were well-led. The clinical leadership had been strengthened following the appointment of three salaried GPs, one of which was the clinical lead.
• The practice obtained and acted on patients views. The Patient Participation Group (PPG) worked in partnership with the practice to improve the services for patients.

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

In addition the provider should:

• Establish an on-going clinical audit programme linked to medicines information, safety alerts and significant events to improve outcomes for patients.
• Ensure that information available to patients enables them to understand the complaints process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 April 2015

The practice is rated as good for the care of people with long-term conditions. Patients were offered an annual health review including a review of their medicines.They also had a named GP to ensure their needs were being met. When needed, longer appointments and home visits were available. Patients’ with long term conditions and other needs were reviewed at a single appointment where possible, rather than having to attend various reviews. Patients were educated and supported to self-manage their conditions. The practice kept a register of patients with complex needs requiring additional support, and worked with relevant professionals to meet their need. Care plans had been developed for such patients, which were kept under review. Carers were identified and supported to care for people with complex long-term conditions.

Updated 23 April 2015

The practice is rated as good for the care of families, children and young people. Priority was given to appointment requests for babies and young children. Systems were in place for identifying and following-up children at risk of abuse, or living in disadvantaged circumstances. The practice worked in partnership with midwives, health visitors and school nurses to meet patients’ needs. Immunisation rates were high for all standard childhood immunisations. Children were able to attend appointments outside of school hours. The practice provided maternity care and family planning services. The practice also provided advice on sexual health for teenagers, and screening for sexually transmitted infections.

Updated 23 April 2015

The practice is rated as good for the care of older people. Patients over 75 years were invited to attend an annual health check, and had a named GP to ensure their needs were being met. The practice worked closely with other services to enable patients to remain at home, where possible. The practice was signed up to an enhanced service to avoid unplanned admissions into hospital, and had identified older patients who were at risk of admissions. Care plans had been developed for such patients, which were kept under review. The practice was also signed up to provide enhanced services for patients with dementia, and proactively screened patients to help facilitate early referral and diagnosis where dementia was indicated. Flu, pneumococcal and shingles immunisations were actively offered to patients. Home visits were carried out to patients unable to attend the practice. Carers were identified and supported to care for older people.

Updated 23 April 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). Patients were offered telephone consultations and were able to book non-urgent appointments around their working day by telephone or on line. The practice offered a ‘choose and book’ service for patients referred to secondary services. This provided greater flexibility over when and where their test took place, and enabled patients to book their own appointments. NHS health checks were offered to patients aged 40 to 74 years, which included essential health checks and screening for certain conditions. The practice also offered health promotion and screening appropriate to the needs of this age group.

Updated 23 April 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice held a register of patients experiencing poor mental health. Patients were offered extended or same day appointments or telephone consultations. When needed, longer appointments and home visits were available. Patients were invited to attend an annual health review, and had an allocated GP to ensure their needs were being met. The practice worked with mental health services to ensure that appropriate risk assessments and care plans were in place, and that patients’ needs were regularly reviewed. Patients were supported to access emergency care and treatment when experiencing a mental health crisis. The practice was signed up to provide enhanced services for patients with dementia, and proactively screened patients to help facilitate early referral and diagnosis where dementia was indicated.

Updated 23 April 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The areas available to patients offered disabled access and a loop hearing system.

For patients who were registered blind or deaf, an alert was in place on the computer system to alert staff to their needs and support they may require. The practice held a register of patients living in vulnerable circumstances including people with learning disabilities. Patients were offered extended or same day appointments or telephone consultations. They were also invited to attend an annual health review, and had an allocated GP to ensure their needs were being met. The practice worked with relevant services to ensure vulnerable people received appropriate care and support. When needed, longer appointments and home visits were available. Carers were identified and offered support, including signposting them to external agencies.