Plas Ffynnon Medical Centre

Updated 8 January 2018

Plas Ffynnon Medical Centre is located in Oswestry and provides primary medical services to patients who live in Oswestry and the surrounding villages. There are 8,972 patients registered with the practice.

The practice has a higher percentage of its practice population in the 65 and over age group than the England average. The practice provides a number of clinics for example asthma, diabetes and heart disease. It offers child immunisations, minor surgery, telehealth dermatology and travel health. The practice also provides a minor injury and phlebotomy service. Plas Ffynnon Medical Centre has a General Medical Services contract.

The practice clinical team includes five GP partners (three male and two female) three salaried GPs, a GP registrar, an Advanced Nurse Practitioner, four practice nurses, four healthcare assistants one of whom provides the phlebotomy service. The practice is supported by a practice manager, deputy practice manager, a clinical services manager, dispensary staff and reception and administrative staff. The practice employs three cleaners, a caretaker and a community and care co-ordinator. The community and care co-ordinator will proactively identify patients and link them to volunteers and networks within the community. Many of the GPs at the practice also have external roles for example with the out of hours service Shropdoc.

The practice is open from 8.15am to 6pm every weekday and the margins to 6.30pm are covered by the out of hours provider. The practice offers extended hours on Saturday mornings from 8.30am to 10.45am. Plas Ffynnon Medical Centre does not provide an out-of-hours service to its own patients but has alternative arrangements for patients to be seen by the out of hours provider Shropdoc when the practice is closed.

Plas Ffynnon Medical Centre is a postgraduate training practice for GP Registrars. GP registrars are doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine. Plas Ffynnon Medical Centre is an accredited training practice for nurses working towards a degree in practice nursing. The practice also have staff on an apprenticeship scheme.

Updated 8 January 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 05 November 2014– Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Plas Ffynnon Medical Centre on 5 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• The partners had reviewed and increased its workforce and employed additional clinicians with a varied skill mix to help meet the health and social needs of patients and the demand for access to appointments.

• There was a structured programme for staff to receive essential training to enable them to carry out their duties safely. We saw that training had been completed or planned.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. Patients commented positively on access to same day appointments.

• The practice enaged with the virtual patient participation group (PPG) to meet the needs of their patients. The PPG reported that the practice sent out emails to them to update them on changes within the practice. They were less active in requesting feedback or suggestions for surveys from them as members. The members spoken with suggested a more interactive model than is currently in place would be an improvement. All were positive about the care and treatment received from clinical staff.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review how clinical supervision sessions with the advanced nurse practitioner are recorded.

• Review the system for recording patient safety alerts received and actioned by the practice.

• Engage with the patient participation group to explore improved ways of gaining feedback.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 February 2015

The practice is rated as good for the population group of people with long term conditions. We found that the nursing staff had the knowledge, skills and competencies to respond to the needs of patients with a long term condition such as diabetes and asthma. The nursing staff were supported by lead GPs for each long term condition. The practice maintained registers of patients with long term conditions. Individual care plans had been developed to support their care needs. We found robust systems in place to ensure that all patients with a long term condition received regular reviews and health checks at a time suitable to them. Staff were proactive in following up patients who did not make appointments for their reviews.

Updated 5 February 2015

The practice is rated as good or the population group of families, children and young people. Staff were knowledgeable about how to safeguard children from the risk of abuse. There were systems in place to identify children who were at risk. There was a good working relationship with the health visitor attached to the practice. There were effective screening and vaccination programmes in place to support patients and health promotion advice was provided. Immunisation rates were in line with or above the local Clinical Commissioning Group average for all standard childhood immunisations. Information was available to young people regarding sexual health and family planning advice was provided by staff at the practice.

Updated 5 February 2015

The practice is rated as good for the care of older people. Every patient over the age of 75 years had been notified of their named GP. The practice had identified vulnerable older patients and had developed individual care plans to support their care needs. These care plans were shared with the out of hour’s provider, with the patient’s permission. Influenza and shingles vaccinations were offered to older patients according to national guidance. Home visits for vaccinations were arranged for older patients who were housebound.

Updated 5 February 2015

The practice is rated as good for the population group of the working-age people (including those who have recently retired and students). The practice offered a range of appointments which included on the day and pre-bookable appointments, as well as telephone consultations. The practice offered extended hours on a Saturday morning. The practice was pro-active in offering on line services as well as a full range of health promotion and screening services which reflected the needs of this age group. The practice offered all patients aged 40 to 74 years old a health check with the practice nurse. Family planning services were provided by the practice for women of working age. Diagnostic tests, that reflected the needs of this age group, were carried out at the practice.

Updated 5 February 2015

The practice is rated as good for the population group experiencing poor mental health (including people with dementia). The practice held registers of patients with mental health needs, including depression and dementia. Patients experiencing poor mental health received an annual health review to ensure appropriate treatment and support was in place. Counselling services held sessions at the practice each week and patients could be referred by their GP or make a self-referral. This enabled patients to receive counselling and treatment in surroundings that were familiar to them.

Updated 5 February 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. We found that the practice enabled all patients to access their GP services. Staff told us that they supported those who were in temporary residence or part of the travelling community to register with the practice. The practice held a register of patients with a learning disability and had developed individual care plans for each patient. The practice carried out annual health checks and offered longer appointments for patients with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice told us they were supported by the community substance misuse team in the care of patients with substance misuse.

Staff knew how to recognise signs of abuse in vulnerable adults. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of hours.