TRINITY MEDICAL CENTRE OUR MISSION STATEMENT Trinity Medical

TRINITY MEDICAL CENTRE

OUR MISSION STATEMENT “Trinity Medical Centre aims to provide a safe, effective and easily accessible range of health services to all our patients within a friendly and confidential environment. Delivered by a dedicated caring team in co-operation with colleagues in other health and social care agencies” Produced by The Practice Team; 20 January 2016

Trinity Medical Centre is a well-established GP Surgery that has operated in this locality since 1988. Prior to this, the practice had operated from previous premises for decades. We try to maintain a list size of between 6, 200 and 6300 patients to ensure a quality service. We currently have five partners, one male and four female We are GP Training Practice We teach 3 rd year Medical Students one morning a week

The Partnership WHO ARE WE? Dr Neil Dowden MBCh. B MRCGP DRCOG 1985 Dundee (Joined 1992) Specialises in Care for the Elderly Dr Ruth Jenkinson MBCh. B MRCGP DRCOG 1986 Edinburgh (Joined 1993) Specialises in Mental Health Dr Jyotsna B Pattekar MBBS DCH D. Obst 1971 India (Joined 1997) Specialises in Gynaecology and Sexual Health as well as Children’s Health Dr Vicki Rouse MBBS MRCGP MRCS (A&E) DRCOG 1995 Newcastle (Joined 2005) Specialises in Diabetes and Sexual Health Dr Renuka Mannikar MBBS DGO MRCOG DFFP MRCGP (Joined 2014) Special interest in Gynaecology, Sexual Health & Mental Health)

RETIREMENT DR PERRINS, OUR SENIOR PARTNER RETIRED AT THE END OF JANUARY THIS WAS AN OPPORTUNITY TO REDEFINE THE PARTNERSHIP INSTEAD OF A SENIOR PARTNER, THE PARTNERS ALL AGREED TO EACH TAKE A LEADER SHIP ROLE IN THE VARIOUS AREAS OF MANAGEMENT AND TO DEFINE ROLES AND RESPONSIBILITES OF EACH PARTNER OUR STRUCTURE NOW LOOKS LIKE THIS

PARTNERSHIP Dr Jenkinson Commissioning Mental Health Safeguarding Lead Dr Rouse HR Diabetes Dr Dowden Prescribing Nursing Homes Dr Pattekar Finance Cancer & Screening Dr Mannikar IT Sexual Health PEOPLE LIVING IN VULNERABLE CIRCUMSTANCE S PEOPLE WITH LONG TERM CONDITIONS OLDER POPULATION WORKING AGE PEOPLE CHILDREN YOUNG PEOPLE & FAMILIES GP TRAINING STUDENTS CONTINUOUS LEARNING AUDITS STUDENTS

Support ing our GPs we have Management A Business Development Manger Practice Manger and a Trainee Practice Manager Nursing Staff: A Nurse Practitioner Two Nurses One Health Care Worker Administrative Staff: One Secretary 6 Receptionists

PRACTICE POPULATION Age Male Female 0 -18 573 548 19 -55 1693 1397 56 -65 436 441 66 -75 333 342 76+ 183 305 Total 3218 3033 6251 (as at 16 May 2016)

ACCESS We feel access is important as it affects all population group and therefore try to offer this to fit in with the needs of our patients. • Offer extended hours suitable for working patients • Offer face time appointments suitable for working age people, people with young families, retired, young population groups • Consultation by email or telephone in addition to face APPOINTMENTS • Same Day ON LINE ACCESS • Appointments • Test Results • Order repeat medication

OUR STRENGTH The Partners have a good skill mix of specialities , which we feel, enable the delivery of a quality service to patients. We feel there is a definite positive advantage to the practice being involved in the training aspect of new GPs as this demands knowledge and skills are kept up to date in all areas of medicine. As a result, the Partners feel they have good clinical leadership skills which is demonstrated by the feedback from students and registrars. We ensure our Care is Safe and Effective by • Attending monthly education sessions • keeping skills updated • Annual Appraisals and Revalidation • Reflective Learning • Reflective review of referrals and deaths The Partnership is stable supported by a Team where some employees have been with us for a number of years The Partners own the building

CORE VALUES Our core values that are shared among the partners and staff are: Openness Fairness Respect Accountability The practice has always prided itself on providing high quality healthcare focussing on preventative care and education in a caring environment. We believe we are respected by our peers and we have built a positive relationship with our consultant colleagues at the local hospital providers.

OUR SERVICE IS WELL LED We have an excellent Management Team with good qualifications and experience We have high personal and professional standards and lead by example, but also by encouraging other to perform to the best of their ability using: • • Appraisals Training Needs Identified Working within Competency Frameworks Developing Policies, Protocols and Procedures The nursing team is led by an excellent Nurse Practitioner with extended prescribing, qualifications and experience. She manages the nursing team to ensure high quality, effective and caring nursing.

We feel this is underpinned by: • • • Practice Business Plan Recruitment and Retention policy and procedures Risk Assessments Learning from Significant Events Weekly Partners Meeting Management Team and Regular Meetings Staff Meetings Full Team Meetings Feedback from our Patients And Feedback from our Team

The practice strives to reach all parts of the population and is working towards inequalities in health and access to all services. We believe the health and well-being of the population to be an important part in reducing costs to the NHS. This can be achieved at the frontline by developing preventative approaches and helping patients to make healthy choices in an environment that supports their physical and mental health and well-being. • Promoting self care is a key element of keeping patients out of the care system. • Providing equal access to services for both walking able and housebound eliminates the current trend of inequalities. • We provide easy access and flexible services. a key aspect of improving service provision. Particularly for the working population • Ensure easy access at the surgery for the walking able and • Home visits for those unable to attend

SERVICES WE OFFER TO OUR PATIENTS We are a GMS Practice and therefore deliver a core set of services as defined in our contract. In addition to this we offer Extended Hours Prostate Cancer Monitoring and treatment Near Patient Testing INR Monitoring (we used to have a one stop clinic) Minor Surgery Smoking Cessation Well established COPD clinic with spirometry Sexual Health including implants and IUCDs On line Access for prescriptions and booking appointments

This what we know: WHAT DO WE FEEL WE DO WELL? Deliver a service around the needs of our patients using the skills and experience of qualified clinicians. Over and above that of our Core Contract. • Minor surgery for the removal of lumps and bumps performed by the GP in a GP setting - convenient and quick for the patient without the need for referral to secondary care • We do Implanon and Coil Insertions and offer this service to the wider community • Joint injections performed by the GP without the need for referral to secondary care • We carry out our own ECGs – patients get instant results and immediate action • We offer a 24 hour BP monitoring service • We offer a home monitoring BP service for patients

• Shared care arrangements with the hospital so that patients can be monitored and receive treatment at the surgery rather than going to hospital (Near Patient Testing; Prostate Cancers) • We proactively risk assessed patients for Osteoporosis or Osteopenia so that treatment could be commenced to prevent or halt this debilitating disease in the elderly. We now do this as a routine in all our clinics. We invite patients in on their 65 th birthday for a risk assessment • Older Population Clinic where the patient has quality time with the nurse and the GP as well as valuable help with the Age UK Adviser. • Links with the local schools where the nurse will do education talks on health. Some comments from patients we surveyed

• We display on the wall who our Doctors are and what their clinical specialised areas are so that patients have the information to make an informed decision on which GP to visit for their problem • The clinicians engage patients in shared care decision making by giving them enough information about their treatment and medication to enable them to make informed choices about their management • Commencement of injectable therapy for Diabetics

WHAT DO WE FEEL WE DO NOT DO SO WELL? This what we WERE aware of: At times our access can let us down but we monitor this and respond when this happens This is what we did: • • • Introduce a new system of same day access Patients are first signposted Patients who feel they need to consult with a GP are given a telephone slot GPs telephone the patient and try to deal with the problem Patients who need a face to face are brought down to the surgery same day What do patients think • Patients love the system as they know they are seen when they need to be seen by the most appropriate person • No unnecessary trips to the surgery or long waits

EFFECTIVE CARE How do we ensure our Delivery of care is EFFECTIVE: • • • Continuous Improvement Cycles Policies and Protocols updated in accordance with Nice Guidelines Continuing Education and Training Reflective Learning Audits GP Attend monthly education sessions and keep skills updated Annual Appraisals and Revalidation Nurses Attend training updates Annual Appraisal and Personal Development Plans Administrative Staff Annual Appraisals Work within a Competency Framework

Good about the Service? Everything, can’t fault it at all, top marks , everyone lovely • Enjoyed tea, nice people • Enjoyed the friendliness of all involved and respected as a person good information • Very friendly and informative Everything done in one go • Access to range of different professionals • Talking to doctors and nurses about my health gave me peace of mind • Cant find fault with anything • Pleasant afternoon out, no complaints • Everything was good Not Good about the service • Lack of space and chairs • Wheelchair access Maybe someone from the centre do a few seated exercises whilst waiting • Not well organised but early days

DELIVERING SAFE CARE IN A SAFE ENVIRONMENT We carry out regular audits on all areas of the practice including clinical and administrative. Recent audits include: • Cancer Diagnosis • Prostate Management of Care • Raised LFTs • BPs • Referrals • HR • Home Visits • Scanning We do this to ensure that everyone works within the Management of Care Guidelines and Protocols

In addition to this we do risk assessments some of which are annual and always when a new service is introduced or following a significant event. Recent Risk Assessments include: • Minor Surgery • New Health Care Assistant • Any New Model of Care • Repeat prescribing by telephone • Isolation Room • Building • Fire Risk • Infection Control Risk The list is not exhaustive We do this to ensure we have covered all potential risks and put measures in place to reduce or eliminate the risk.

What we feel underpins our delivery of safe care; We have Policies and Procedures in place for all clinical and administrative tasks which are regularly reviewed. In particular • Safeguarding • Infection Control • Health & Safety • Information Governance Significant Events Are reviewed for learning outcomes at both clinical and administrative meetings and shared with the whole Team. We have a robust reporting process in place and everyone is encouraged to be involved in a non blame culture. We employ the right people for the right job and ensure they have the skills to carry out the job they are employed to do

How do we know our Delivery is Effective? • The majority of our Diabetic Patients are well controlled (practice diabetic clinic) • External Diabetic Audit Results were excellent • Chronic Disease Management well managed with annual reviews • Supported by QOF achievements • Smoking Cession figures increased • Cancer Care Reviews demonstrate care has been appropriate • We audit all deaths and this demonstrate effective care • Re audits show improvement • Annual Reviews • Medication Reviews • Care Plans Review • Patient Feedback

ARE WE A CARING PRACTICE? Patients are treat with dignity and respect by the whole team Confidentiality is adhered to by the whole team Patients are supported with information on services, treatment and pathways Our Patients tell us we are • Surveys around the consultation “Did the doctor treat you with care and concern” • Cards and Letters from patients telling us • Comments on surveys from patients telling us COMMENTS FROM OUR PATIENTS • It’s a very good practice • The doctors are always caring, the staff are always helpful, have always been able to get appointments • Always prompts treatment • The doctors always have time to listen. The staff are pleasant and obliging • Never get to see a doctor

MORE COMMENTS • Ease of booking appointments. Waiting time is not excessive. • I can always get an appointment quickly if I need one. Receptionists friendly and up to date with my medical history • Good GPs • Some doctors very good, not so good, some go extra mile and some don’t! • It will be nice to have a new updated building. All the people who work in this practice wonderful. • No it is fine as it is. Staff are very helpful • Nothing I love the practice all the staff do their very best with the greatest of care, they are simply the best. • For my needs I find the service totally adequate. • Nothing to improve, I have been a patient of this practice and former practices (Dr Main) very happy with all aspect that have touched me and my family. • Nothing, very happy with the care provided • Service I had today was good, staff very friendly and helpful doctor polite. Good advice from both and COPD check up. • My family and myself are happy with the service we receive. • Have a way of contacting deaf people and for them to contact surgery other than by phone • More time for patients feel like we have to hurry up saying about our health problems

WE DELIVER A PROACTIVE AND RESPONSIVE CARE We listen to our patients • • • Suggestions Feedback from Surveys Friends and Family Complaints Patient Reference Group Changes we have made in response to patients are: • Install automatic front door opening • Somewhere to leave bikes securely • Change the front reception desk for disabled or less tall patients. • Being able to order repeat medication over the telephone • Exploring opening on a Saturday • Information on Self Care and Pathways • Same day access