Caterham Valley Medical Practice

Updated 10 June 2016

Caterham Valley Medical Practice provides general medical services to approximately 9,000 registered patients. The practice delivers services to a slightly higher number of patients who are aged 65 years and over, when compared with the national average. Data available to the Care Quality Commission (CQC) shows the number of registered patients suffering income deprivation is lower than the national average.

Care and treatment is delivered by four GP partners and one salaried GP. Three of the GPs are male and two are female. The practice employs a team of three practice nurses, a care coordinator and a healthcare assistant. GPs and nurses are supported by the practice manager and a team of reception and administration staff.

The practice is a GP training practice and supports undergraduates and new registrar doctors in training. The practice was the winner of Health Education England (Kent, Surrey and Sussex) (HEKSS) educational award in 2015.

The practice is open from 8.30am to 6.30pm on weekdays.

Services are provided from:

Eothen House

Eothen Close

Caterham

CR3 6JU

The practice has opted out of providing out of hours services to its own patients and uses the services of a local out of hours service, IC24.

Updated 10 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Caterham Valley Medical Practice on the 16 February 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• 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 consistently and strongly positive. 

• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. 
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 June 2016

The practice is rated as good for the care of people with long-term conditions.

• GP Partners and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Nationally reported data showed that some outcomes for long-term conditions were comparable with national averages. For example, the percentage of patients with diabetes in whom the last IFCC-HbA1c was 64mmol or less in the preceding 12 months was 79.79% compared with a national average of 80.4%.
• Longer appointments and home visits were available when needed.
• A well-being advisor provided advice and support to patients with long-term conditions, within the practice on one day each week. The advisor sign-posted patients to other support organisations, including the voluntary sector and social care services.
• Patients received a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 June 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.
• Nationally reported data showed that patient treatment outcomes were comparable with national averages. For example, 77 % of patients with asthma, on the register, had an asthma review in the preceding 12 months compared to a national average of 72%
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• 83.6% of eligible female patients had a cervical screening test compared to the national average of 81%.
• The practice offered a walk-in surgery every morning and daily telephone triage appointments with the duty GP.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with health visitors.
• The practice worked closely with community midwives who were based within the practice premises and ran twice weekly ante-natal clinics from the practice.

Updated 10 June 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older patients and offered home visits and urgent appointments for those with enhanced needs.
• The practice had appointed a care co-ordinator who worked closely with the GPs to monitor patients at high risk of unplanned admissions and to ensure timely review of care plans.
• The practice had a dementia lead and all staff had received dementia awareness training.
• The practice provided care and support to patients who were resident in two nursing and five residential homes, each of which was supervised by a named GP. The largest nursing home received a regular weekly ward round.
• The practice held monthly multi-disciplinary meetings and held strong links with the community matron, and district nursing staff who were based at the surgery.

Updated 10 June 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.
• The practice offered extended hours appointments on two mornings and one evening each week for working patients who could not attend during normal opening hours.
• Telephone appointments were available with a doctor or a nurse.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 10 June 2016

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

• Performance for mental health related indicators was comparable with or above the national averages: 95% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the last 12 months compared with a national average of 93%; the percentage of those patients who had a record of their alcohol consumption in the preceding 12 months was 95.7% compared with a national average of 92.4%; 88% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was higher than the national average of 83%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Patients were able to self-refer to psychological therapies and counselling, which were offered in-house. The ability to self-refer was aimed particularly at male patients who had traditionally been reluctant to engage with such services.
• The practice 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 patients with mental health needs and dementia. 

Updated 10 June 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 homeless patients, travellers and those with a learning disability.
• Care and support was provided to patients with a learning disability living in two nearby residential facilities.
• The practice offered longer appointments for patients with a learning disability and flexible appointments for carers and those cared for.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.
• The practice well-being advisor informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.