Topsham Surgery

Updated 11 September 2018

This report relates to the regulatory activities being carried out at Topsham Surgery which is situated in the coastal town of Topsham. Topsham Surgery is comprised of two sites; the main site is at Holman Way, Topsham EX3 0EN and the branch surgery is located at Glasshouse Lane, Countess Wear, Exeter EX2 7BT. We visited both these sites during our inspection. The practice has a website which is located at www.topshamsurgery.gpsurgery.net.

The deprivation decile rating for this area is nine (with one being the most deprived and 10 being the least deprived). The practice provides a primary medical service to approximately 10,750 patients of a diverse age group. The 2011 census data showed that majority of the local population identified themselves as being White British.

There is a team of eight GP partners, four female and four male; the partners are supported by one salaried GP and two GP registrars. The whole time equivalent of GPs is approximately five. The GP team were supported by a practice manager, an office manager, an information technology manager, an administration manager, four practice nurses, three health care assistants and additional administration staff.

Patients using the practice also have access to health visitors, counsellors, carer support workers, district nurses, midwives and other health care professionals who visited the practice on a regular basis.

The Topsham location is open from 8.30am to 6pm Monday to Friday. The Glasshouse location is open 8.30am to 5.30pm. Appointments are offered between those times. Extended hours are offered at Topsham from 6.30pm until 7.45pm Monday to Thursday and two Saturday mornings a month from 9.30am until 1pm. Outside of these times, including from 8am to 8.30am and 6 to 6:30pm, patients are directed to contact the out of hour’s service and the NHS 111 number. This is in line with local contract arrangements.

The practice offers a range of appointment types including face to face same day appointments, telephone consultations and advance appointments (six weeks in advance) as well as online services such as repeat prescriptions.

Updated 11 September 2018

This practice is rated as Good overall. (Previous rating July 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Topsham Surgery on 24 July 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice worked closely with a local charity and one of the practice GPs chaired the local Estuary League of Friends which offered befriending and support for patients without family or friends and helped them access benefits and arrange social or personal care.
• The practice provided care plans and annual reviews to patients at a local drug and alcohol dependency unit which housed approximately 35 patients.
• The practice participated in the clinical commissioning group Referrals Enhanced Service. This was a service which provided reasons for referrals, examined any outliers and offered specialist support as a result. For example, a musculoskeletal (MSK) specialist had visited the practice to give a presentation to GPs following high numbers of referrals to a MSK specialist.

We saw two areas of outstanding practice:

• There was supported housing for survivors of domestic abuse and a home for patients with long term mental illness within the practice area. The nurse manager provided in-house training for staff at these homes, as well as providing appropriate vaccinations and regular health checks.
• The practice provided a weekly surgery at the West of England School for the blind and partially sighted. This provided a high level of care and treatment for around 40 children and young adults with complex special needs and complex prescribing.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Updated 11 September 2018

Updated 11 September 2018

Updated 11 September 2018

Updated 11 September 2018

Updated 11 September 2018

Updated 11 September 2018