Updated 13 December 2019
The provider, Carfax Health Enterprise Community Interest Company, delivers regulated activities from its three main locations. This inspection report covers our visit to Great Western Surgery on 25 November 2019. The addresses for the three sites are:
Great Western Surgery
Farriers Close,
Swindon.
SN1 2QU
Tel: 01793 421311
Website:
Carfax NHS Medical Centre
Swindon Health Centre,
Swindon.
SN1 2DQ
Tel: 01793 541655
Website: www.carfaxhealthcare.co.uk
Sparcells Surgery
Peatmoor,
Swindon.
SN5 5AN
Tel: 01793 881928
Website:
The practice is based in Swindon, Wiltshire, and is one of 25 serving the NHS Swindon Clinical Commissioning Group (CCG) area. Great Western Surgery is arranged over two floors. All patient services, including nurse treatment rooms and GP consulting rooms, are located on the ground floor.
The practice has approximately 5,463 registered patients from an area surrounding the practice and Swindon town centre. The practice age distribution is broadly in line with the national average, with most patients being of working age or older. Great Western Surgery is a member of a federation of practices, The Brunel Health Group. The aim of the federation is to provide a support network across practices.
Great Western Surgery is a teaching facility for medical students and provides placements to nursing students. Since our previous inspection in June 2018, the practice has also become a GP training practice, and has implemented joint services as part of The Brunel Health Group, such as shared home visiting by paramedic staff.
The practice was taken over by the current provider in January 2017, and an Alternative Provider Medical Services (APMS) contract is in place. An APMS contract is a locally negotiated contract open to both NHS practices and voluntary sector or private providers (for example, walk-in centres).
Great Western Surgery provides the following regulated activities:
- Treatment of disease, disorder or injury
- Diagnostic and screening procedures
- Family planning
- Maternity and midwifery services
- Surgical procedures
Great Western Surgery’s management team also manages Carfax NHS Medical Centre and Sparcells Surgery. They are based at the Carfax site and split their time as required between the three locations. Great Western Surgery operates a nurse-led model of care. This means that all the clinicians work together within their own areas of competence, to ensure that patients are seen by the most appropriate person to meet their needs, also allowing them to build and maintain a workforce of appropriately skilled nurses.
Members of the clinical and administrative teams work across all three sites. There are four salaried GPs (two female, two male). One of the salaried GPs is a medical team manager, responsible for managing and supporting the GPs across the three locations. The wider clinical team consists of an advanced nurse practitioner, a treatment room nurse, two chronic disease nurses and two Health Care Assistants (HCAs). A clinical pharmacist is also employed by the practice.
All members of the administrative team undertake additional roles, such as staffing reception, and working as medical secretaries, and are managed by an office manager. The provider's corporate team includes a Medical Director, a Director of Nursing, a Director of Operations, an infection control nurse (who is also the practice chronic disease nurse), and a range of corporate administrative staff. Each of the Directors are based in a different practice so that there is a Director available at all times. Each practice also has an Operations Manager.
Eighty-three per-cent of the practice population describes itself as white, and around 17% as having a Black, Asian and Minority Ethnic (BAME) background. A measure of deprivation in the local area recorded a score of 6, on a scale of 1-10. A higher score indicates a less deprived area. (Note that the circumstances and lifestyles of the people living in an area affect its deprivation score. Not everyone living in a deprived area is deprived and not all deprived people live in deprived areas).
Average male and female life expectancy for the practice is 79 and 83 years respectively, and mirrors national averages.
Great Western Surgery is open from 8am to 6.30pm, Monday to Friday, the practice answers telephone calls during these times. Routine GP appointments are generally available from 8am to 12.30pm and 1.30pm to 5.30pm, Monday to Friday. The practice provides (pre-booked only) extended hours appointments, for patients from all its locations, at its Carfax Street location. These are from 6.30pm to 8pm on Monday, Tuesday and Friday.
The practice has opted out of providing Out-Of-Hours services to its own patients. Outside of normal practice hours, patients can access the NHS 111 service, and an Out-Of-Hours GP service, which is operated by the local acute Trust. Information about the Out-Of-Hours service was available on the practice’s website, in the patient registration pack, and as an answerphone message.