Archived: Dr Russell Thorpe Also known as The Old Links Surgery

Updated 8 September 2016

Old Links Surgery is located in Highbury Road East, St. Annes, Lancashire. The practice is located in a bungalow in a residential area. There is easy access to the building and disabled facilities are provided. There is a car parking on the road in front of the practice. Primary medical services are provided under a General Medical Services (GMS) contract with NHS England and the practice is part of the Fylde and Wyre Clinical Commissioning Group.

There is one GP working at the practice. He is the provider of the service. There is one part-time female practice nurse, a part-time practice manager and a team of administrative staff.

The practice opening times are 8.30am to 7pm Monday, 8.30 till 6.30pm Tuesday, 8.30 till 5pm Wednesday, 8.30 till 7pm Thursday and 8.30 till 6pm Friday.

The practice appointment times are; Monday to Friday: 8.30am to 10.30 and Monday 5pm to 6.30pm, 4.30 to 6pm Tuesday, 5 to 6.30 Thursday and 4 to 5.30pm Friday.

Patients requiring a GP outside of normal working hours are advised to call Fylde Coast Medical Services using the usual surgery number and the call will be re-directed to the out-of-hours service.

There are 1976 patients on the practice list. The majority of patients are white British with a high number of elderly patients and patients with chronic disease prevalence.

Updated 8 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Old Links Surgery on 21 April 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. However on the day of our inspection the practice did not demonstrate an effective system for ensuring fire safety. This was rectified within three working days.

• Systems were 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.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about services and how to complain was available and easy to understand.

• Patients said they found it easy to make an appointment with the GP and that there was continuity of care, with appointments frequently 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.

The areas where the provider should make improvements :

• Consider the development of “Easy to read” information for those who require it.

• Ensure all equipment & facilities are regularly maintained and tested

• Ensure the staff recruitment procedure is revised to include written confirmation of verbal references and forms of identification checks

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 September 2016

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

• The practice had a robust chronic disease programme which included:

• Annual review call and recall programme with a clinician for all patients with chronic disease.
• The Practice nurse undertook the review of patients with chronic disease and had a special interest in diabetes.
• Annual medication reviewed for all patients on repeat medication, with robust procedures for non-compliant patients.
• Longer appointments were offered for patients with multiple conditions.
• Home visits carried out by the GP for house bound patients with chronic disease.
• A wall chart was used to monitor results of anticoagulation tests so that the results were immediately reported to the GP or followed up if delayed.

• The practice offered diabetic foot screening call and recall. CQC data indicated that the practice achieved 91% for annual foot checks in patients with diabetes compared to the national average of 88%.
• Post-hospital discharge care plan reviews were carried out with patients who attended A&E unnecessarily
• Continuity of care was delivered by seeing the same GP thereby reducing consultation time and allowing more time for the presenting problem that day. The GP had experience of what previous treatments had been the most effective with that patient.

Updated 8 September 2016

The practice was rated as good for the care of families, children and young people.

• The practice had high achievement with their childhood immunisation programme achieving for immunisations.

• There were safeguarding procedures in place for children who were vulnerable. All staff received regular safeguarding training. The GP was the lead for child & adult safeguarding.

• Childhood flu immunisations were offered and promoted via posters in the waiting room.
• The practice nurse undertook all midwifery checks at a time most convenient to the patient.
• There was a programme for flu and whooping cough vaccinations in pregnant women.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and younger patients who had a high number of A&E attendances.

• 83% of patients with asthma, on the practice register,had an asthma review in the preceding 12 months that included an assessment of asthma control using the 3 RCP questions. This compared to a national average of 75%.

• 77% of women aged 25-64 were recorded as having had a cervical screening test in the preceding 5 years.This compared to a national average of 82%.

• Parents could access their GP at short notice without making early morning telephone calls for appointments.

Updated 8 September 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 patients.
• The practice offered home visits and same day appointments for those with enhanced needs.
• Care plans and health checks were provided as needed with regular medicine reviews carried out.
• The practice supported patients who lived in nursing and residential homes by undertaking home visits when needed and providing advice over the telephone.
• The practice offered flu, pneumonia and shingles vaccination programmes.

• Referrals to other services were made regularly, for example to antenatal clinics and the mental health team.

• Where the patient was at risk of Emergency Admission to hospital a Care Plan was created for them as part of the Alternative to Unplanned Admission Enhanced Service. The patient was given a copy of the plan to keep by the phone in case they need medical assistance urgently.

Updated 8 September 2016

The practice was rated as good for the care of working-age people (including those recently retired and students).

• The practice had a very flexible appointment system and patients could access their GP at short notice without calling early in the morning to get an appointment.

• Routine appointments started at 8.30 every day and evening surgeries ran to 6.30pm on Monday and Thursdays, 6pm on Tuesday and 5.30 on Friday thus enabling people with daytime commitments to access their GP.

• Patients could book routine appointments up to eighteen months in advance online.

• The practice promoted online services to make it easier for patients who worked to access services outside of practice hours.

Updated 8 September 2016

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

• The practice had leaflets and posters in the waiting room with information regarding dementia, mental health and carer support.

• The staff team had been stable for many years. The familiar faces and voices were felt to be reassuring for those with mental health problems.

• Patients were monitored as part of QOF to check that they had an up-to-date care plan from the Mental Health Team. These plans were scanned on to the patient’s record to ensure the GP was fully aware of the most recent diagnosis and support plan.

• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months.This compared to a national average of 88.47%.

• 76% of patients diagnosed with dementia had their care reviewed in a face-to-face review in the preceding 12 months. This compared to a national average of 84.01%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

Updated 8 September 2016

The practice was rated as good for the care of people whose circumstances may make them vulnerable.

• Patients with a learning disability or other significant disability were known to the GP which meant staff could quickly identify when dealing with a patient that they may require additional assistance.
• The practice had a register of vulnerable adults and children so that staff were alerted when they attended for appointments.
• Clinical staff were trained in the mental capacity act. There were procedures in place for identifying patients with a DOLS in place.

• The practice regularly worked with multi-disciplinary teams in the case management of patients deemed to be vulnerable.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

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