Aldborough Surgery

Updated 20 December 2017

Aldborough Surgery provides services to approximately 3,400 patients in Aldborough, a rural area in North Norfolk. The practice is able to offer dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. The practice also works closely with a local transport charity to ensure patients are able to access the surgery and other health care locations.

The practice has one male GP partner and two female salaried GPs. There is a practice manager and a finance and facilities manager who work on site. The practice employs one nurse practitioner, one practice nurse and one healthcare assistant. Other staff include three dispensers, a dispensing manager, three receptionists, a lead receptionist, one secretary and two administrative assistants. The practice holds a General Medical Services contract with North Norfolk Clinical Commissioning Group (CCG).

The practice works closely with a local organisation to inform patients of a transport scheme to help patients get to appointments at the surgery and local hospitals as transport links in the area are minimal. The practice is open between 8.30am and 6pm Monday to Friday. Appointments can be booked up to six weeks in advance with GPs and nurses. Urgent appointments are available for people that need them, as well as telephone appointments. Online appointments are available to book up to one month in advance.

When the practice is closed patients are automatically diverted to the GP out of hour’s service provided by Medicom. Patients can also access advice via the NHS 111 service.

We reviewed the most recent data available to us from Public Health England which showed the practice has a smaller number of patients aged 0 to 39 years old compared with the national average. It has a larger number of patients aged 50 to 84 compared to the national average.

Income deprivation affecting children is 11%, which is lower than the CCG average of 13% and the national average of 20%. Income deprivation affecting older people is 11%, which is lower than the CCG average of 12% and national average of 16%. The practice have 1% of the population recorded as a non-white ethnic group. Life expectancy for patients at the practice is 82 years for males and 87 years for females; this is higher than the CCG and England expectancy which is 79 years and 83 years respectively.

Updated 20 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Aldborough Surgery on 22 June 2017. The overall rating for the practice was requires improvement, with requires improvement for providing safe and well led services. The full comprehensive report on the 22 June 2017 inspection can be found by selecting the ‘all reports’ link for Aldborough Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 08 December 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 22 June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good, and good for providing safe and well-led services.

Our key findings were as follows:

• All equipment in the emergency trolley was in date. There was a comprehensive policy and log in place to support the new system.

• All prescriptions were signed by the relevant clinician prior to being dispensed to patients.

• The practice had implemented a new written consent form for minor surgeries. The records we viewed showed this was being used. The practice ran monthly audits on all patients who had undergone minor surgery to ensure consent had been gained in the appropriate way. The audits showed there was an effective system in place and all patients had written consent recorded where this was appropriate.

• The practice had taken action relating to fire and legionella risk assessments and these were recorded appropriately.

• There was a system in place to monitor the use of blank prescription stationary which was in line with relevant guidance.

• The practice had a new meeting agenda in place to ensure effective sharing of all significant events within the practice. These were attended by all staff within the practice.

• The management team could demonstrate improved oversight of safety within the practice and had implemented a new meeting schedule to improve communication within the practice and with external stakeholders.

Further improvements from the last inspection included:

• The practice had actively been educating patients on the shared summary care records, which allows patients records to be shared between healthcare services, with consent. Records showed that in the previous two months, consent for this had increased.

• The practice had reviewed the flu vaccination recall system and as a result had vaccinated 175 more patients than the end of the flu season last year. This was still ongoing at the time of this inspection.

• The practice had been proactive in inviting patients for health checks and had utilised text messages as a communication method.

• The practice offered contraceptive implants to patients. Due to the rural location of the practice and surrounding areas, the practice also accepted referrals from other local practices. The practice ensured there was flexibility in the appointments system to allow for increasing referrals and carried out extra clinics when demand was higher to ensure this did not impact negatively on registered patients. A salaried GP was also working with the local clinical commissioning group to develop a similar service for the fitting of implants to reduce menstrual bleeding. This service was currently only offered in secondary care and the practice was keen to set the service up to reduce travel and referral waiting times for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 December 2017

Updated 20 December 2017

Updated 20 December 2017

Updated 20 December 2017

Updated 20 December 2017

Updated 20 December 2017