Archived: Dr Richard Hirson

Updated 27 August 2015

Manea Surgery in Manea, Cambridgeshire provides services mainly to patients living in Manea and the surrounding area. The practice is managed by an individual GP. The practice also employs one part-time salaried GP. There is one nurse and there are two healthcare assistants active in the practice. The clinical team is supported by a team of administration and dispensing staff. The practice has a dispensary lead by a dispensary manager. The practice has a patient population of approximately 2100. The practice is open every weekday between 08:30 and 17:30. Extended hours are provided on Tuesday evenings until 19:45. The practice website clearly details how patients may obtain services out-of-hours.

Updated 27 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manea Surgery on 14 July 2015. The overall rating for this practice is good. We found the practice to be good for providing safe, effective, caring, responsive and well-led services. The quality of care experienced by older people, by people with long term conditions and by families, children and young people is good. Working age people, those in vulnerable circumstances and people experiencing poor mental health also receive good quality care. Our key findings across all the areas we inspected were as follows:

• The practice was a friendly, caring and responsive practice that addressed patients’ needs and that worked in partnership with other health and social care services to deliver individualised care.
• The premises were clean and tidy.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Patients had their needs assessed in line with current guidance and the practice had a holistic approach to patient care. The practice promoted health education to empower patients to live healthier lives.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Where the practice had highlighted the need for improvement of the premises an action plan had been implemented.
• The staff worked well together as a team.

We saw one area of area of outstanding practice:

• The lead GP actively engaged with the local community which had led to the implementation of several community initiatives such as walking groups, bowling groups and social gatherings. The lead GP also provided anticipatory home visits to older patients in the community and provided us with examples where they had organised community events and combined these with vaccination or health check awareness for patients.

However there was one area of practice where the provider needs to make improvements. Importantly the provider should:

• Improve the arrangements for undertaking appraisals of staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 August 2015

The practice is rated as good for the care of people with long-term conditions. Patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the staff worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Repeat prescriptions provided explanations around medication, stating its purpose and why it was prescribed.

Updated 27 August 2015

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 on the safeguarding register. Immunisation rates were generally above local averages for standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies.

The practice ran occasional vaccination clinics with the addition of family fun elements, such as bouncy castles.

Updated 27 August 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care.

The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The lead GP had long standing patient knowledge allowing for recognition of changing needs in this patient group, for example increasing frailty and loneliness. This had led to the implementation of several community initiatives such as walking groups, bowling groups and social gatherings.

The lead GP provided anticipatory visits to older patients in the community.

Updated 27 August 2015

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 late appointments one day a week and a full range of health promotion and screening that reflects the needs for this age group.

Updated 27 August 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It had carried out advance care planning and clinical audits for patients with dementia. The practice kept a register of patients with mental health illness which comprised of 12 patients, of which eight were considered to have severe mental health illness. Of these eight, seven had comprehensive care plans in place.

The practice had advised patients experiencing poor mental health about how to access various support groups and voluntary organisations, including access to a community psychiatric nurse and counselling services. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 27 August 2015

The practice is rated as good for the care of people whose circumstances might make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. The practice provided a flexible approach to consultations for these patients.

Performance for palliative care related 2013-2014 QOF indicators was higher at 100% than the local average of 99.5%.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had advised vulnerable patients about how to access various support groups and voluntary organisations.

The lead GP had extensive experience of working with drug users due to previous roles and applied the experience in the treatment of addictive drug users by providing easy access and supervised dispensing. 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.