Archived: Tall Trees Surgery

Updated 23 July 2015

Tall Trees Surgery is located in Retford. The practice provides services for approximately 5,365 patients under the terms of the locally agreed NHS Primary Medical Services contract. The practice catchment area is classed as within the group of the fifth less deprived areas in England. The age profile of the practice population is broadly similar to other GP practices in the Bassetlaw Clinical Commissioning Group (CCG) area.

The practice is situated within a purpose built health centre in Retford. There are three GP partners, two male and one female, who work at the practice. They are supported by two nurse practitioners, one practice nurse, one healthcare assistant, a team of administrative staff and a practice manager.

This practice is to merge with a neighbouring GP practice which is located in the same building. Preparations for the merger were underway and some administration functions were being shared at the time of the inspection. The managers and administration team of both practices had recently undergone changes to their role to support the merger.

The practice is open weekdays from 8am to 6.30pm with extended opening every Tuesday morning from 7.30am and extended closing on Tuesday and Thursday until 7pm. Minor surgery, diabetes, asthma, family planning, antenatal and mother & baby clinics are run each week. Out of hours care is accessed via the surgery telephone number or calling the NHS 111 service.

Tall Trees surgery is registered to provide; diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and the treatment of disease, disorder or injury from Retford Primary Care Centre, Retford Hospital, North Road, Retford, Nottinghamshire, DN22 7XF.

Updated 23 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tall Trees Surgery on 10 March 2015. Overall the practice is rated as good.

Specifically we rated the practice as good in providing safe, effective, caring, responsive and well-led care for all of the population groups it serves.

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 appointments, 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.
• Patients reported appointment times sometimes never ran to schedule and they waited 15 minutes past their appointment time to be seen

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 July 2015

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. These patients also had access to the dedicated telephone number to contact the practice which was answered 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 their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. ‘Exercise on prescription’ was available for patients whom would benefit from physical activity to support them managing their medical condition.

Updated 23 July 2015

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. Patients told us children and young people 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. Practice nurses offered a confidential service providing contraceptive advice to teenagers via the C card scheme

Updated 23 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. Twelve percent of the practice population were over 75. All these patients had a named GP and a structured annual review to check their health and medication needs were being met. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. These patients had access to a dedicated telephone number to contact the practice which was answered as a priority. Staff at the practice referred patients to support groups to help them maintain their independence.

Updated 23 July 2015

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 reflecting the needs for this age group.

Updated 23 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All 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 people experiencing poor mental health, including those with dementia. It carried out advanced care planning for patients with dementia. The dementia diagnosis rate was above the national average and 92% of these patients had an annual review compared to the local average of 83%.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It 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. Staff had received training on how to care for people with mental health needs and dementia.

Updated 23 July 2015

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 such circumstances including those with a learning disability. It had carried out annual health checks for people with a learning disability and all of these patients had received a follow-up. Longer appointments were also offered for people with a learning disability.

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