The Southbroom Surgery

Updated 21 January 2016

The Southbroom Surgery is located within a converted building. Consultation rooms are located across three floors with lift access to each floor. The practice population has grown significantly since 2011 expanding from 9,500 to the current 11,300. This results in a significant challenge because the practice premises cannot be expanded and space is at a premium. Data shows minimal income deprivation among the practice population. There are a higher number of patients aged under four years, and also in the age range 40 to 54, than the local and national average.

The practice is managed by a managing GP partner supported by a senior administrator and the nurse manager. There are eight GPs at the practice and they make up the equivalent of five point four whole time GPs. Six of the eight GPs are male. There is a nursing team of ten. The nurse manager, four practice nurses, three health care assistants and two phlebotomists (a phlebotomist takes blood tests). Administration and reception services are provided by a team of 16. The practice is a training practice and supports two qualified doctors training to be GPs at any one time. Teaching opportunities for medical students are also offered.

Services are delivered via a Personal Medical Services (PMS) contract. PMS contracts are negotiated by the practice with the local office of NHS England.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8.30am to 12pm every morning and 2.30pm to 6pm daily. Extended hours surgeries are offered every morning. On Monday from 6.30am, on Tuesday and Friday from 7.30am and on Wednesday and Thursday from 7.20am. These early morning surgeries are available for booking in advance.

The practice has opted out of providing out of hours services to their patients. Out of hours services are provided by Medvivo. The out of hours service is accessed by calling NHS 111. There are arrangements in place for services to be provided when the surgery is closed and these are displayed at the practice and in the practice information leaflet.

All services are provided from: The Southbroom Surgery,15 Estcourt Street, The Green, Devizes, Wiltshire, SN10 1LQ.

Updated 21 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of The Southbroom Surgery on 25 November 2015.

Overall the practice was rated as good. Specifically we found the practice good for the provision of safe, effective, caring, responsive and well led services. Consequently we rated the provision of services to all six population groups as good.

Our key findings included:

• 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 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 the services provided was available and was easy to understand. This included how to make a complaint and how to provide feedback.

• Patients’ satisfaction with the care and treatment they received was higher than other practices in the locality.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was a clear leadership structure with resilience built in and staff felt supported by management.

• The practice proactively sought feedback from staff and patients, which it acted on.

• The practice was aware of and complied with the requirements of the Duty of Candour.

There were areas of service delivery where the practice needs to make improvements.

Importantly the practice should:

• Consistently record the results of checks of emergency equipment.

• Ensure the risk assessment for medicines held to respond to an emergency is formalised.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The practice achieved 99% of the QOF diabetes targets compared to the CCG average of 96% and national average of 89%.

• 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 medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 21 January 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 patients who were on the at risk register.
• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice was above the national average for cervical smears achieving 79% compared to the national average of 77%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives and health visitors.

Updated 21 January 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 in its population.
• It was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was higher than the CCG and national averages.

• Care and treatment of older people reflected current evidence-based practice

Updated 21 January 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.
• Early morning appointments were available every weekday and telephone consultations were available for patients who found it difficult to attend the practice during normal opening hours.
• Use of online services and e-mail correspondence was promoted.
• 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 21 January 2016

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

• All the patients with a severe mental health problem who had not declined an appointment had their care reviewed during a face to face appointment with their GP.

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

• It 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.

• It 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 21 January 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 carers, travellers and those with a learning disability.

• It offered longer appointments for patients with a learning disability.

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

• It had told 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.