Regent Street Surgery

Updated 18 July 2016

Regent Street Surgery is a long established family orientated GP practice located in Stonehouse, Gloucestershire. The practice is situated in a single storey, purpose built health centre building and is wheelchair accessible with automatic doors to the practice.

The practice provides general medical services to approximately 4,165 patients. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. (A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The Practice has two GP partners and two salaried GPs (three female and one male) which is equivalent to two and a quarter whole time equivalent GPs. The clinical team includes two practice nurses and one healthcare assistant (all female). The practice manager is supported by an assistant practice manager and a team of five receptionists.

Regent Street Surgery is a dispensing practice with four of the reception team being qualified to work in the dispensary on a rotational basis. The practice dispenses to approximately 33% of the registered patient base.

The practice population has a higher proportion of patients aged between 15 and 19 compared to local and national averages. For example, 11.5% of practice patients are aged between 15 and 19 compared to the local clinical commissioning group (CCG) and national averages of 6%. This is due in part to the practice supporting a local university and college.

The practice is located in an area with low social deprivation and is placed in the second least deprived decile by public health England. The prevalence of patients with a long standing health condition is 49% compared to the local CCG average of 55% and the national average of 54%. People living in more deprived areas and with long-standing health conditions tend to have greater need for health services.

The practice is open between 8am and 6.30pm on Monday to Friday. Appointments are available between 8.15am and 1pm every morning and 2.15pm to 5.30pm every afternoon. Extended surgery hours are also offered Monday to Thursday evenings between 6.30pm and 7.30pm.

Out of hours cover is provided by South Western Ambulance Service NHS Foundation Trust and can be accessed via NHS 111.

The practice provided its services from the following address:

Regent Street Surgery

73 Regent Street

Stonehouse

Gloucestershire

GL10 2AA

This was the first inspection of Regent Street Surgery.

Updated 18 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Regent Street Surgery on 16 June 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. However, on the day of our inspection we found that an out of date controlled medicine from 2014 had not been disposed of.
• 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.
• 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 improvement are:

• Ensure there is a robust and consistent system in place for disposing of out of date controlled medicines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 July 2016

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

• The practice had specialist nurses for diabetes and respiratory disease who provided both chronic and acute management of these patients within their area of expertise. Support from a GP was available if needed, and patients at risk of hospital admission were identified as a priority.

• Performance for overall diabetes related indicators in 2014/15 was 100% which was above both the clinical commissioning group average of 95% 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 18 July 2016

The practice is rated as good for the care of families, children and young patients.

• 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 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 patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding five years in 2014/15 was 88% which was above both the clinical commissioning group average of 84% 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, health visitors and school nurses through minutes of monthly multidisciplinary meetings.

Updated 18 July 2016

The practice is rated as good for the care of older patients.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example in dispensing, dementia, influenza and pneumococcal immunisations.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• Patients who were discharged from hospital were flagged by the administration team to prompt a GP review of the patient and their care plans.

• The practice participated in a “Village Agent” scheme run by the local County Council to facilitate access to benefits and services to patients over the age of 55.

Updated 18 July 2016

The practice is rated as good for the care of working-age patients (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. A 24 hour automated appointment booking system was also available.

• The practice had a virtual patient reference group in addition to the patient participation group to enable working age patients to contribute.

• Clinics available included in house phlebotomy (blood testing), acute aortic screening, minor surgery, joint injections, spirometry (lung function testing), 24 hour electrocardiogram (ECG) monitoring, international normalised ratio (INR) monitoring and NHS health checks.

• Extended hours surgery were offered Monday to Thursday evenings for working patients who could not attend during normal opening hours. Bookable telephone appointments were also available.

Updated 18 July 2016

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

• 90% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months (04/2014 to 03/2015), which is above both the clinical commissioning group average (CCG) of 86% and the national average of 84%.

• Performance for mental health related indicators was 100% which was above both the CCG average of 97% and national average of 82%.

• 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 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 18 July 2016

The practice is rated as good for the care of patients 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 had easy read practice leaflets for patients with learning disabilities.

• The practice had a carers champion, carers notice board and offered carers health checks.