Central Surgery

Updated 5 June 2017

Central Surgery provides a range of primary medical services to the residents of Sawbridgeworth and the surrounding area. The practice has been at its current purpose built location of Bell Street, Sawbridgeworth, Hertfordshire, CM21 9AQ, since 1972.

The practice population is pre-dominantly White British with a higher than average number of patients aged from 40 to 79 years and a lower than average number of patients aged from 15 to 34 years. National data indicates the area is one of low deprivation. The practice has approximately 12,200 patients with services provided under a nationally agreed general medical services (GMS) contract.

There are two GP partners, one male and one female and they employ six salaried GPs, one male and five female. The nursing team consists of one nurse practitioner, two practice nurses and two health care assistants, all female. The practice employs a practice manager and there are a number of reception and administrative staff led by the assistant practice manager and the reception manager.

The practice is open from 8am to 6.30pm Monday to Friday and offers extended opening hours from 6.30pm to 7.30om on Tuesdays and Wednesdays and alternate Saturday mornings from 9am to 12pm.

When the practice is closed out of hours services are provided by Herts Urgent Care and can be accessed via the NHS 111 service.

Updated 5 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Central Surgery on 16 March 2016. The overall rating for the practice was good with requires improvement for safe.

The full comprehensive report from the March 2016 inspection can be found by selecting the ‘all reports’ link for Central Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 11 May 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 16 March 2016. 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 in all areas.

Our key findings were as follows:

• The practice had a clearly defined and embedded system and process in place to manage the receipt and action of patient safety alerts and MHRA (Medicines Healthcare products Regulatory Agency) alerts.
• Control of substances hazardous to health (COSHH) risk assessments for the cleaning products used in the practice had been completed.
• Risk assessments had been completed for staff carrying out chaperone duties to determine if a check through the Disclosure and Barring Service was required.
• The stock levels of controlled drugs were recorded in a bound book to avoid anyone tampering with the record.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 July 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.
• Performance for diabetes related indicators was better than the CCG and national average. The practice achieved 98% of available points compared to the CCG average of 89% and the 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 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 12 July 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 people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 90%, which was better than the CCG average of 83% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives and health visitors.

Updated 12 July 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 people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• A member of the nursing team carried out home visits for older patients with complex needs or those who had had an unplanned admission to hospital.
• A phlebotomy service was available for frail and elderly patients who found it difficult to attend the hospital.

Updated 12 July 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.
• Extended opening hours appointments were available.
• 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.
• The practice used social media to communicate health information advice to their patients.

Updated 12 July 2016

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

• 86% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.
• Performance for mental health related indicators was better than the CCG and national average. The practice achieved 100% of available points, with 6% exception reporting, compared to the CCG average of 96% and the national average of 93%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice 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.
• The practice 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 12 July 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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice informed 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.
• There was an identified member of staff who was the carer’s champion and they had received training for this role from the local CCG.