Newent Doctors Practice

Updated 19 April 2016

Newent Doctors Practice is a rural dispensing practice located in Newent which is approximately 10 miles from Gloucester. The practice catchment area includes rural areas of Gloucestershire and Herefordshire including Dymock, Upleadon, Highnam, Huntley and Upton Bishop. The practice is situated on the ground floor of the building and is wheelchair accessible with automatic doors and a lift to the health education room which is also accessed by several steps.

The practice is approved for training qualified doctors who wish to become GPs and provides general medical services to approximately 10,600 patients. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. (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 seven GP partners (five female and two male) which equated to six and a half whole time equivalent GPs. The clinical team include three practice nurses (all female) and three phlebotomists (all female). The practice manager is supported by a reception manager and a team of six receptionists and two secretaries.

Newent Doctors Practice is a dispensing practice, the dispensary is managed by a dispensary manager who is supported by four dispensers.

The practice population has a higher proportion of patients aged between 65 and 69 compared to local and national averages. and a lower proportion of patients aged between 30 and 34 compared to local and national averages

According to national data there are pockets of deprivation in Gloucestershire; however the practice is located in an area with minimal deprivation. The prevalence of patients with a long standing health condition is 50% compared to the local CCG average of 55% and national average of 54%. Patients living in more deprived areas and with long-standing health conditions tend to have greater need for health services.

The practice is open between 8.30am and 6.30pm on Monday to Friday. Appointments are available between 8.30 am and 11.30am every morning and 2pm to 6pm every afternoon. Early appointments are available Monday to Friday between 7am and 8am.

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:

Newent Doctors Practice

The Holts Health Centre

Watery Lane

Newent

Gloucestershire

GL18 1BA

This is the first inspection of Newent Doctors Practice.

Updated 19 April 2016

We carried out an announced comprehensive inspection at Newent Doctors Practice on 1 March 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 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.
• 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. (Duty of Candour is a legal duty to ensure providers are open and transparent with patients who use services. It also sets out specific requirements providers must follow when things go wrong with care and treatment, including informing patients about the incident, providing reasonable support, providing truthful information and an apology when things go wrong).

The areas where the provider should make improvement are:

• Ensure that appropriate actions are taken following medicines incidents.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 April 2016

The practice is rated as good for the care of patients 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. Both of the nurses leading on diabetes had attended the Warwick training course and a third nurse specialised in stroke and heart disease.

• Performance for overall diabetes related indicators was 95% which was comparable to the clinical commissioning group (CCG) average of 95% 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 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. The practice held quarterly multidisciplinary meetings with community based staff.

• Diabetes education was offered in house and audit results identified that this had significantly improved patients attendance levels.

• To support patients to receive care closer to home the practice offered diabetic eye screening, aneurysm screening, acupuncture and phlebotomy services.

Updated 19 April 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.

• 75% of patients with asthma on the register had a review in the last 12 months which was comparable to the national average of 75%.

• Patients told us 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 was 85% which was above the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice held child flu clinics during the schools October half term to support high attendance and access rates.

• We saw positive examples of joint working with midwives, health visitors and school nurses through minutes of monthly multidisciplinary safeguarding meetings.

• There were district nurses, health visitors and midwives based services located at the practice and a child physiotherapist and a speech and language therapist also held regular clinics at the practice.

Updated 19 April 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 shingles, influenza and pneumococcal immunisations.

• The practice participated in the care home enhanced service and provided regular reviews and visits for patients.

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

• The practice worked together with a local transport provider ‘dial a ride’ to ensure that suitable appointments were available for patients using this service.

• There were podiatry and physiotherapy services based at the practice to provide services closer to home for older patients.

Updated 19 April 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 reflects the needs for this age group.

• The practice offered extended hours appointments for working age patients from 7am to 8am Monday to Friday.

Updated 19 April 2016

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

• 85% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was higher than the national average of 84%.

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

• A mental health nurse and a consultant psychiatrist for the elderly attended the practice to see patients that were referred by their GP.

• 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 trust fund which paid for counselling support at the surgery for patients that were referred from their GP; this has been running for 20 years.

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

Updated 19 April 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 patients, travellers and 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 patients and also held quarterly meetings.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice accommodates regular clinics for a consultant psychogeritician, a drug and alcohol team and a community psychiatric nurse.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff was 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 took part in a local social prescribing initiative whereby patients with non-medical issues, such as debt or loneliness could be referred by a GP to a single hub for assessment as to which alternative service might be of most benefit.