Archived: Drs Clayton & Rogers Also known as Dodington Surgery

Updated 9 June 2016

Drs Clayton, Rogers & Evitts, also known as Dodington Surgery, is located in Dodington, Whitchurch, Shropshire. It is part of the NHS Shropshire Clinical Commissioning Group. The practice has a history of providing GP services to its local population since 1885. The total practice patient population is 4,995. The practice, in line with the local Clinical Commissioning Group (CCG), has a higher proportion of patients aged 65 years and over when compared with the practice average across England. For example, the percentage of patients aged 65 and above at the practice is 25%, the local CCG practice average is 24% and the national practice average, 17%.

The staff team comprises two full time GP partners, supported by three locum GPs who provide services on a sessional basis. The practice is in the process of updating their registration with the Care Quality Commission as one GP Partner had resigned at the end of April 2016.The clinical practice team comprises of one nurse practitioner, two practice nurses, a health care assistant and two counsellors. The practice is managed and supported by a practice manager, seven administration staff and a Community Care Co-ordinator. In total there are 17 full or part time staff employed. The practice is also a training practice for foundation year two (FY2) medical students.

The practice is open Monday to Friday 8.30am to 6.30pm (excluding bank holidays). The practice provides just under 600 appointments each week with the GPs, nurses and health care assistant. The practice offers pre-bookable appointments and telephone access appointment for all patients who require an urgent (same day) appointment. Urgent appointments are also available for patients that need them. The practice does not provide an out-of-hours service to its own patients but has alternative arrangements for patients to be seen when the practice is closed through Shropdoc, the out-of-hours service provider. The practice telephones switches to the out-of-hours service at 6pm each weekday evening and during weekends and bank holidays.

The practice provides long-term condition management including asthma and diabetes. It also offers child immunisations, minor surgery and travel vaccinations. The practice offers NHS health checks and smoking cessation advice and support. The practice has a General Medical Services (GMS) contract with NHS England. This is a contract for the practice to deliver General Medical Services to the local community or communities. They also provide a number of Directed Enhanced Services, for example they offer minor surgery and the childhood vaccinations and immunisation scheme.

Updated 9 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Clayton, Rogers & Evitts, also known as Dodington Surgery, on 3 May 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 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:

• Adopt a more proactive approach to identifying and meeting the needs of carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 June 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 diabetes related indicators was better than the national average. For example, the percentage of patients on the diabetes register, with a record of a foot examination and risk classification was 93%, compared to the CCG average of 88% and national average, 88%.

• 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 9 June 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 practice’s uptake for the cervical screening programme was 87%, which was comparable to the CCG average of 83% 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 9 June 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 including their registered patients in care homes.

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

• The frailest two per cent of the practice patients had a hospital admission avoidance care plan in place which highlighted their needs and wishes and was reviewed regularly. All admissions of patients with these plans were discussed to see if they were avoidable.

Updated 9 June 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 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 9 June 2016

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

• Performance for the mental health related indicators was better than the local CCG and 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 9 June 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 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.