Studholme Medical Centre

Updated 9 June 2016

Studholme Medical Centre is based in a large Edwardian house, which has been modernised internally and extended, located in central Ashford. The areas in which patients receive treatment are on the ground floor and first floor. The practice holds a contract to provide personal medical services and at the time of our inspection there were approximately 15,800 patients on the practice list.

The practice has recently undergone some significant changes including the retirement of several partners and the recruitment of a managing partner who acts as practice manager.

The practice has two GP partners (one male, one female) and six salaried GPs (three male, three female). They are supported by two pharmacists, three nurse practitioners, four nurses, three health care assistants, a managing partner and an administration team consisting of secretaries, administrators and receptionists.

The practice is open between 8am and 6pm Monday to Friday. Extended hours appointments are offered at the following times; 6.30pm to 8pm Mondays and Wednesdays and 8am to 11am every Saturday. When the practice is closed between 6pm and 6.30pm patients are advised to call the surgery phone number where they will be redirected to an answering service who will then pass the information to the practice doctors; between 6.30pm and 8am patients are advised to call NHS 111 where they will be given advice or directed to the most appropriate service for their medical needs.

The service is provided from the following location:

Studholme Medical Centre

50 Church Road

Ashford

Middlesex

TW15 2TU

The practice has a slightly higher than average number of patients aged 45-54 years and those over 65 years, there is a slightly lower than average number of patients aged 5 to 35 years. The practice also has a slightly lower than average number of patients with long standing health conditions.

Updated 9 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Studholme Medical Centre on 14 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.
• 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.

We saw areas of outstanding practice:

• The practice set up and facilitated a number of patient led groups such as support for prostate cancer and families in unusually traumatic circumstances. Patients told us these had been of great benefit to them.
• The practice employed two pharmacists to provide support to the patients during surgery opening hours. We saw several examples where the pharmacist, working in conjunction with a named GP, had a positive patient impact with improved understanding about their medicines and how to take them, we also saw examples of better compliance with medicine regimes and improved patient engagement both with the surgery and other services including the local authority.

The areas where the provider should make improvement are:

• Continue to monitor patient satisfaction including access to GPs, appointment booking and opening hours.
• Continue to pro-actively identify carers.
• Ensure that a robust system of annual appraisals is maintained.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 June 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.

• 78% of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less was with the same as the national average 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 multidisciplinary package of care.

Updated 9 June 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.

• 80% of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding 5 years was comparable with national average 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.

Updated 9 June 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.

• The practice pharmacists worked with older people to ensure that they understood how to take their medication and that they did not run out.

Updated 9 June 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 and an automated 24 hour telephone booking system, as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 9 June 2016

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

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

• 79% of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was slightly lower than the national average 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 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 9 June 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.