Archived: The Ilchester Surgery

Updated 24 September 2015

We inspected the location of Ilchester Surgery, 17 Church Street, Ilchester, Yeovil, Somerset, BA22 8LN, where all the registered regulated activities were carried out.

The practice serves approximately 3300 patients who live in Ilchester and the surrounding areas. The national general practice profile shows the practice has a higher than England average population of female patients from birth to 9 years old and 40 to 49 years. The male patient population was higher than average from birth to 19 years and 50 years to 69 years old. The practice has below the national and local average for females between 15 to 29 years and male from 25 to 49 years old. The practice is sited in one of the least deprived areas in their patient catchment area.

There were two GP partners and one salaried GP. They were currently advertising for another salaried GP as one had recently left. Regular locums were used to cover any absences in cover. There was one male and two female GPs. The GPs worked the equivalent to two full time GPs.

The nursing team consisted of; a nurse practitioner, two practice nurses and a healthcare assistant.

The practice has a General Medical Services contract with NHS England. The practice is contracted for a number of enhanced services including extended hours access, facilitating timely diagnosis and support for patients with dementia, minor surgery, patient participation, immunisations and remote care monitoring.

Additional services are provided from the practice premises including midwife clinics twice a week, a dietician once a month and a podiatrist twice a month.

Patients were able to contact the practice between 8:30am and 6:30pm Monday to Friday. Between 8am and 8:30am the duty GP was available to deal with any patients queries. Out of these hours the practice refers their patients to NHS 111 operated by Vocare called Somerset Doctors Urgent Care.

Updated 24 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Ilchester Surgery on 13 August 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• 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.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

• Devise a plan of clinical audits to complete depending on the needs of the population and ensure all clinical audits are completed to ensure improvements were made and there is shared learning between the team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 September 2015

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. 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 medicine 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 September 2015

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 people who had a high number of A&E attendances. Immunisation rates were high for all standard childhood immunisations. Patients told us children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. 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, health visitors and school nurses.

Updated 24 September 2015

The practice is rated as good for the care of older people.

Nationally reported data from the Quality Outcomes Framework showed that outcomes for patients were good for conditions commonly found in older patients. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, in dementia and end of life care. They were responsive to the needs of older patients, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 24 September 2015

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.

Updated 24 September 2015

The practice is rated as good for the care of patients experiencing poor mental health (including patients with dementia). We saw 94% of patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. They carried out advance care planning for patients with a diagnosis of dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations, such as children and mental health services and Somerset initiatives such as GetSet and talking therapies. They had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 24 September 2015

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 homeless people, travellers and those with a learning disability. They had carried out annual health checks for patients with a learning disability and 100% of these patients had received an annual review. They offered longer appointments for patients with a learning disability, where necessary.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. They 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, documenting safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.