Archived: The Oliver Street Surgery

Updated 15 August 2016

The Oliver St Surgery is based at the Health Centre, 57 Oliver Street, Ampthill, Bedfordshire and has a branch Surgery at Wilstead Methodist Church, Whitworth Way, Wilstead MK45 3DB. We did not inspect the branch surgery on the day of inspection.

The practice serves a population of approximately 3,700 patients with slightly higher than average populations of females aged 35 to 39 and 45 to 49 years and males aged 45 to 70 years. There are marginally lower than average populations of patients aged 0 to 4 years and lower than average populations of females aged 70 to 85 years and over. The practice population is largely White British. National data indicates the area served is one of low deprivation in comparison to England as a whole.

The clinical team consists of two GP Partners; one male and one female, one male salaried GP, two practice nurses and one phlebotomist. The team is supported by a practice manager and a team of administrative staff. The practice holds a General Medical Services (GMS) contract for providing services, which is a nationally agreed contract between general practices and NHS England for delivering general medical services to local communities. It is also a teaching practice, receiving medical students from the Cambridge University Medical School.

The practice operates from a purpose built property, which is shared with another GP practice and a number of community services. There is a shared car park to the rear of the surgery, with designated disabled parking spaces available.

The Oliver St Surgery is open between 8am and 6.30pm Monday to Friday. In addition, pre-bookable appointments are available until 8pm on Mondays. The practice offers a phlebotomy service which is available from 8am until 11.30am every other day.

The services provided at this location include midwifery, childhood immunisations, childhood surveillance, minor surgery, travel clinics, joint injections, cryotherapy, family planning, antenatal/postnatal care, sexual health, diagnostic and screening procedures, cervical screening, immunisations and minor illness.

The out of hours service is provided by Care UK and can be accessed via the NHS 111 service. Information about this is available in the practice and on the practice website and telephone line.

Updated 15 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oliver St Surgery on 12 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 and an effective system 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 been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• Any child under the age of five years was offered an appointment two days after their original consultation to reassure their parent or guardian.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had introduced an observation sheet for completion during a medical emergency.
• 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 improvement are:

Continue to identify and support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 August 2016

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

• Nursing staff had lead roles and received regular training in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was comparable to the Bedfordshire Clinical Commissioning Group (CCG) and national averages. For example, the percentage of patients with diabetes, on the register, in whom the last blood glucose reading showed good control in the preceding 12 months, was 68%, where the CCG average was 76% and the national average was 78%.
• 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 multi-disciplinary package of care.

• The practice arranged home visits for patients in this group to monitor their long term conditions.
• Personalised care plans for this group were completed and there was a recall system in place to ensure patients were reviewed regularly and appropriately.

• There were GP leads for individual long term conditions.
• The practice utilised external specialist clinicians who attend the practice and assisted in supporting non-compliant patients.

Updated 15 August 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 79%, which was comparable to 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.
• The practice referred new mums and children with eating problems to a weight management programme specifically for this group.
• The practice offered a sexual health awareness clinic for patients aged 14 to 19 years.
• Family planning and contraceptive advice was available.
• Any child under the age of five years was offered an appointment two days after their original consultation to reassure their parent or guardian.

Updated 15 August 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. 
• Annual health checks were available for patients in this group.

• Medication control boxes were available for repeat medication.
• The practice offered flu immunisation at home for those patients unable to attend the practice.
• Any unplanned attendance at accident and emergency, hospital admission or discharge, on review, were followed up by the practice within three days of receipt of discharge information.

Updated 15 August 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.
• 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, including ‘Well man’ and ‘Well woman’ checks.
• The practice had enrolled in the Electronic Prescribing Service (EPS) in 2015. This service enabled GPs to send prescriptions electronically to a pharmacy of the patient’s choice.
• The practice offered catch-up and ongoing vaccination both proactive and opportunistic for students returning home.
• On line services were available for booking appointments and prescription ordering.
• The practice offered extended hours appointments until 8pm on Mondays and telephone triage for patients unable to attend during normal surgery hours.

Updated 15 August 2016

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

• The percentage of patients with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months (01/04/2014 to 31/03/2015) was 93% where the CCG average was 84% and the national average was 84%.
• Performance for mental health related indicators were otherwise comparable to local and national averages. For example, the percentage of patients with diagnosed psychoses who had a comprehensive agreed care plan was 82% where the CCG average was 87% and the national average was 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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 A & E 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.
• The practice was part of a mental health triage hub, providing patients access to counselling and wellbeing psychologists.
• The GPs carried out weekly ward rounds in the local dementia care home.

Updated 15 August 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 homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.
• The practice held a register of patients who were also carers and same day appointments were available to this group as a priority.
• Vulnerable patients who were unable to attend the practice were contacted by telephone, or offered home visits.
• The practice worked with local pharmacies to deliver patient’s medication to their home addresses when needed.