Twyford Surgery

Updated 25 February 2016

Twyford Surgery, Hazeley Road, Twyford, Winchester, Hampshire, SO21 1QY.

The practice has an NHS General Medical Services contract to provide health services to approximately 9,600 patients in and around the villages of Twyford and Colden Common. The purpose built practice is situated in the village of Twyford.

The practice has a branch located at Colden Common. During this inspection we did not inspect the branch. Management of both sites is organised at Twyford.

In 2007, the practice opened an independent pharmacy at the location which was integrated with a practice dispensary.

The practice has three GP partners and three salaried GPs, two of whom are male and four are female. The practice also has three practice nurses. The GPs and the nursing staff are supported by a practice manager, a dispensary manager and a team of staff who carry out dispensary, administration, reception, scanning documents and secretarial duties.

The practice has had a longstanding commitment to training. All staff are involved and we saw there was open door policy to ask which received good feedback from doctors undergoing training. At any one time, the practice supports up to four doctors training to become GPs.

The practice is open between 08:00am and 6.30pm Tuesdays to Fridays and from 08.30am to 7.15pm on Mondays. The practice is also open Saturday 08.30am to 11.30am for booked appointments.

Appointments types offered by the practice are routine, book on the day and emergency. The practice also operates a walk in clinic. The practice offers double appointments and occasional special appointments for complex patients. The practice offers patients reminders for appointments via text messaging.

The practice has opted out of providing out-of-hours services to their own patients and refers them to the Out of Hours service via the NHS 111 service.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Twyford Surgery on 10 December 2015. 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 that 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:

When monitoring risks to patients ensure that they keep a check on dates that assessments and servicing of equipment is due to be carried out.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 February 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.

• 91% of patients with diabetes had been seen at the practice in the preceding 12 months.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 25 February 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.

• 82% of women aged 25-64 had a cervical screening test in the preceding five years.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw good examples of joint working with midwives and health visitors.

Updated 25 February 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.

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

• The practice has signed up to a Dementia enhanced service offering dementia assessments for patients.

Updated 25 February 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 provided Saturday morning and Monday evening appointments for patients who could not attend in the practice’s usual opening hours.

• 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.

Updated 25 February 2016

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

• 78% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.

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

• It 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.

• It 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 people with mental health needs and dementia.

Updated 25 February 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 and those with a learning disability.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told 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.