Woolston Lodge Surgery

Updated 24 November 2016

The Woolston Lodge Surgery was inspected on Wednesday 21 September 2016. This was a comprehensive inspection.

The main practice is situated in Woolston, an area of Southampton. The practice provides a general medical service to 13,600 patients covering the areas of Woolston, Itchen, Peartree, Sholing, Thornhill, Bitterne, Weston, Netley and Hamble. There is also a branch practice in Mitchell Close in another area of Woolston.

The practices population area is in the fourth decile for deprivation, which is on a scale of one to ten. The lower the decile the more deprived an area is compared to the national average. The practice population ethnic profile is predominantly White British. The practice has a slightly higher elderly population than the national averages with 8.66% of the practice list aged over 75 years. The average male life expectancy for the practice area is 79 years which is the same as the national average of 79 years; female life expectancy is 83years which again is the same as the national average of 83 years.

There is a team of five GP partners, four male and one female and three salaried GPs providing 6.75 WTE GP posts. The GP partners hold managerial and financial responsibility for running the business. The team are supported by a practice manager, an assistant practice manager, a finance manager, three nurse practitioners, four practice nurses, a healthcare assistant, a phlebotomist (Phlebotomists are people trained to take blood samples), 24 additional administration and reception staff and one apprentice.

The practice is also a teaching practice for medical students and student nurses.

Patients using the practice also have access to community nurses, mental health teams and health visitors and other health care professionals who visit the practice on a regular basis.

The practice is open between 8am and 6.30pm Monday to Friday. Booked appointments are offered between these times. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments. Extended hours are offered on a Monday, Wednesday, and Thursday mornings from 7.30am to 8am and on Monday evening until 8pm. The practice also opens one Saturday a month between 8.30am and 12pm for pre booked appointments. Outside of these times patients are directed to contact the NHS 111 service. Details are also given on the practice website of other useful telephone numbers and addresses where patients can seek assistance when the practice is closed.

The practice has a General Medical Services (GMS) contract with NHS England.

The Woolston Lodge Surgery provides regulated activities from the main site at the Hazeleigh Medical Centre, Southampton, SO19 9AL and its Spitfire surgery at 39 Spitfire Court, Mitchell Close, Woolston, Southampton. SO19 7TN. We did not visit the branch practice at this inspection.

Updated 24 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woolston Lodge Surgery on 21 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. The practice was clean, tidy and hygienic. We found suitable arrangements were in place which ensured the cleanliness of the practice was maintained to a high standard.
• The practice was run efficiently and was well organised. 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 is:

• Review the processes for identifying carers in the practice to increase those being identified and to offer carers support and guidance about available services.

• Review how information about Saturday appointments canbe better explained to patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 November 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.

• Performance for patients with long-term conditions compared with national averages. For example, 86% of patients with asthma, on the register, had had an asthma review in the preceding 12 months, compared to the national average of 75%. The review included three patient-focused outcomes that acted as a further prompt to review treatment.

• The practice held half yearly meetings with diabetes consultants to achieve the best outcomes for patients.

• 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 24 November 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.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in a target period of three-and-a-half or five-and-a-half years was 81%, which was comparable to the CCG average of 84% and the national average of 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 24 November 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.

• Older patients with complex care needs or those at risk of hospital admission had personalised care plans.These were shared with local organisations to facilitate continuity and proactive care.

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

Updated 24 November 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 had a 24 hour, seven day a week automated phone system to check, make or cancel appointments that was particularly beneficial for working patients.

• 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 24 November 2016

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

• 90% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was better than both the clinical commissioning group (CCG) average of 86% and national average of 84%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in their records in the preceding 12 months was 95%, which was better than the national average of 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 24 November 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.