Painswick Surgery Also known as Hoyland House

Updated 27 March 2017

Painswick Surgery is located in a rural area of Gloucestershire.

The practice is managed by three partners, one GP employed as a GP retainer and one locum GP who regularly works at the practice. There was a female GP available to see patients who preferred to see a female doctor, There is one practice nurse and two health care assistants at the practice. There is an administrative team led by a practice manager. The practice is a training practice.

The practice has a higher than average population of older people. There is also a high prevalence of people living with dementia and learning disabilities. The general Index of Multiple Deprivation (IMD) population profile for the geographic area of the practice is in the second 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. 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 82 and 84 years, which is above the national average of 79 and 83 years respectively.

The practice is part of the Gloucestershire Clinical Commissioning Group .

The practice provides its service to approximately 4,900 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 is open between 08.30am and 6pm Monday to Friday. Appointments are from 8.30am to 11am every morning and 4pm to 6pm daily. When the practice is closed patients are advised, via the practice website and an answerphone message, to ring the NHS on 111 for advice and guidance.

Painswick Surgery is registered to provide services from the following location:

Gyde Road,

Painswick,

Stroud,

Glostershire,

GL6 6RG.

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

This was the first inspection of Painswick Surgery.

Updated 27 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Painswick Surgery on 13 June 2016. Overall the practice is rated as good.

Specifically, we found the practice good for providing safe, effective, responsive, caring and well led services.

Our key findings 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.

• We found that completed audit cycles were driving positive outcomes for patients.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• 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 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 March 2017

The practice is rated as good for the care of patients with long term conditions.

• The GPs and nursing team had the knowledge, skills and competency to respond to the needs of patients with long term conditions such as diabetes and chronic obstructive pulmonary disease (COPD, which is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease).

• The percentage of patients on the register for diabetes who had had influenza immunisation in the preceding 12 months in 2014-2015 was higher than the national average and the clincical commissioning group (CCG) average.

• The percentage of patients with diabetes with a record of a foot examination and risk classification within the preceding 12 months was higher than the national average and the CCG average.

• Patients with long-term conditions were routinely screened by the GPs for anxiety and depression to ensure that their needs were met.

Updated 27 March 2017

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 Accident and Emergency (A&E) attendances.

• Immunisation rates for standard childhood immunisations (12 months, 24 months and five years) given in 2014/15 were comparable to the clinical commissioning group (CCG) average.

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

• The practice worked proactively with midwives and health visitors.

• The practice’s uptake for the cervical screening programme was 80% which was comparable to the CCG average of 84% and the national average of 82%.

• There were same day and triage appointments were available for children and young patients every working day including evenings.

Updated 27 March 2017

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. Older patients had a named GP.

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

• The premises were accessible to those with limited mobility.

• There were good working relationships with external professionals such as district nurses.

• There was an on site phlebotomy service.

• The practice followed up on newly discharged patients and maintained an ‘avoiding admissions’ register.

Updated 27 March 2017

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.

• Health promotion and screening reflected the health needs of this group.

• The practice accommodated non-registered students who were at home from university and for whom it was difficult to access their registered GP out of term times. The practice also communicated with those patients electronically via text and email if necessary when they returned to university.

• Appointments were available from 8.30am until 11am and between 4pm and 6pm at night.

• NHS health checks were offered to all patients aged 40 -74.

Updated 27 March 2017

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

• 75% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• 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 27 March 2017

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

• The practice offered longer appointments for patients with a learning disability.

• The practice worked closely with local residential learning disability services to meet the needs of patients living in those services.

• The practice regularly worked with multi-disciplinary teams 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.