Archived: The Corinthian Surgery

Updated 12 October 2016

The Corinthian Surgery is a GP partnership close to Cheltenham town centre. The practice is located on the first floor within St Paul’s Medical Centre which is a modern purpose built building and is wheelchair accessible with automatic doors and a lift. The practice has seven consulting rooms and two treatment rooms.

The practice provides its services to approximately 8650 patients under a General Medical Services (GMS) contract. (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 delivers its services from the following location:

St Pauls Medical Centre,

121 Swindon Road,

Cheltenham,

Gloucestershire,

GL50 4DP

The practice partnership has seven GP partners making a total of approximately five whole time equivalent GPs. There are three male and four female GPs. The clinical team includes a nurse practitioner, two practice nurses and two health care assistants, all of which are female. The nursing team are directly supported by a senior nurses’ receptionist and a nurse receptionist. The practice management and administration team consist of a practice manager, a business manager, an office manager, two practice secretaries, two administrative clerks, a senior receptionist and four receptionists. The practice is approved for teaching medical students from the University of Bristol.

The practice population demographic is aligned with local and national averages. The general Index of Multiple Deprivation (IMD) population profile for the geographic area of the practice is in the fifth least deprivation decile. (An area itself is not deprived: it is the circumstances and lifestyles of the people living there that affect its deprivation score. It is important to remember that not everyone living in a deprived area is deprived and that not all deprived people live in deprived areas). Average male and female life expectancy for the practice is 79 and 83 years, which is in line with the national average of 79 and 83 years respectively.

The practice is open from 8.30am to 6.30pm Monday to Friday. The practice operates a range of appointments times between 9am to 6pm Monday to Friday. Extended hours are available from 7.30am to 8.30am on Mondays and 7am to 8.30am on Wednesdays. The practice is closed on every first Wednesdays of the month between 12.30pm and 2pm for training. When the practice is closed during core hours, calls are diverted to a call handling service (Message Link), who will divert any urgent calls to a designated member of staff at the practice.

The practice has opted out of providing out of hours services to its patients. Patients can access the out of hours services provided by South Western Ambulance Service NHS Foundation Trust via the NHS 111 service.

Updated 12 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Corinthian Surgery on 7 September 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 most staff felt supported by management. The practice proactively sought feedback from staff and patients, which it mostly acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Review the infection control audit to highlight improvements made and include review dates.

• Ensure training records are reviewed and kept up to date and that mandatory training is repeated as needed in a timely way for example fire safety.

• Continue to improve the support and care of patients with long term conditions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 October 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.

• The practice achieved 98% of the targets for care of patients with diabetes in 2014/15 which was above both the clinical commissioning group 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 nurses visited housebound patients with long term conditions to complete annual reviews.

• The practice used self-management plans, particularly for asthma and chronic obstructive pulmonary disease (a chronic lung disease) and supported a small number of patients who had home monitoring through Telehealth (a system where information about the patient’s condition is monitored remotely and the information sent to a clinician at the practice without the need for the patient to attend the practice).

• The practice participated in the winter resilience program. They provided additional appointments between January and March primarily for patients diagnosed with chronic obstructive pulmonary disease to avoid unnecessary hospital admissions. All the practice patients could access the additional appointments.

Updated 12 October 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 the cervical screening programme was 80% which was comparable to the clinical commissioning group average of 84% and national average of 82%.

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

• The safeguarding lead GP held regular child safeguarding meetings with health visitors, school nurses and community midwives.

Updated 12 October 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.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. Nurses visited patients in care homes and those who were housebound to offer and administer flu vaccines.

• The practice supported two care homes and provided fortnightly “ward rounds” to patients living in those homes.

• The practice held weekly meetings which the district nurses and health visitors were invited to attend.

Updated 12 October 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.

• The practice offered extended hours every Mondays from 7.30am and Wednesdays from 7am.

• The practice participated in a Gloucestershire scheme called ‘Choice Plus’, which provides additional GP appointments for patients with acute on the day problems at various locations in the county.

Updated 12 October 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 was above the clinical commissioning group (CCG) average of 86% and the national average of 84%.

• The percentage of patients with severe mental health problems who had a comprehensive, agreed care plan documented in their record, in the preceding 12 months (04/2014 to 03/2015) was 95% compared to the CCG average of 93% and national average of 88%.

• The practice had a nominated nurse who was responsible for inviting patients who had mental health problems in for annual review. This involved a physical health check, lifestyle advice and completing a mental health care plan. The lead nurse for mental health gave us positive examples of how they encouraged patients to attend reviews.

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

• A primary mental health care nurse held clinics at the practice once a week and the practice had links to a community dementia nurse.

• The practice carried out advance care planning for patients living 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 12 October 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 those with a learning disability.

• The practice supported a local residential home for patients with learning disabilities. Patients living in the home had a named GP who visited annually to offer health checks.

• 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 through social prescribing.

• 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 also supported a local alcohol and drug rehabilitation unit. There was an alcohol support worker attached to the practice who offered weekly appointments for patients who needed to be seen.