Archived: Dr Atchison and Partners

Updated 14 March 2017

Dr Atchison and Partners, also known as Queens Road Surgery, is located at 8 Queens Road, Buckland, Portsmouth, Hants, PO2 7NX. The practice is housed in a purpose built two storey detached building in a suburb of Portsmouth.

The practice has an NHS Personal Medical Services contract to provide health services to approximately 5415 patients and the practice area covers the whole of the Portsmouth area. The practice is an urban, city centre practice with a varied and diverse population. There is a high instance of deprivation and an increasing elderly population. The practice is part of the Portsmouth clinical commissioning group.

The building is at ground level making it accessible for all. There is a spacious waiting room with reception, consulting rooms and treatment room. There are three consulting rooms with adjoining examination rooms and a treatment room. There are further rooms on the first floor with a conference room, office room and a consulting room.

The practice currently has two full time partner GPs and a salaried GP, two of whom are male and one who is female. The practice has two practice nurses. The practice uses regular locums to provide cover where needed.

The clinical team are supported by a practice manager and a team of seven receptionists, a typist and administration support staff. One of the receptionists is also able to work as a health care assistant.

The practice is open from 8am to 6.30pm, Monday to Friday. Routine pre-bookable appointments are available up to four weeks in advance. The practice offered urgent same day appointments. Appointments could be made on line, in person or by telephone. The practice aimed to see all patients within 72 hours for routine appointments and on the same day for urgent problems. Urgent consultations are available daily with the triage GP. Telephone consultations are also available on a daily basis.

Extended hours for pre-bookable appointments only are available on Saturdays from 8.30am to 11.30am.

The practice has opted out of providing out-of-hours services to their own patients and refers them to the out of hours service via the NHS 111 service.

Updated 14 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Atchison and Partners (also known as Queens Road Surgery) on 21 January 2016. Overall the practice was rated as good. The practice was rated good for providing effective, caring, responsive and well-led services, but requires improvement for providing safe care.

This was because the practice needed to update infection control polices and training for staff according to their role, and carry out actions in response to infection control audits to improve patient outcomes. The practice also needed to complete the recommendations in their 2015 fire assessment to improve fire safety

The full comprehensive report on the January 2016 inspection can be found by selecting the ‘all reports’ link for Dr Atchison and Partners on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 17 January 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 21 January 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as ‘good’ in the safe domain. Overall the practice is remains rated as good.

Our key findings at this inspection were as follows:

• The practice recorded all significant events in detail, with learning points relayed to staff at meetings and recorded in minutes with action points if applicable.
• The practice had updated the safeguarding policy and adult safeguarding training has now been given to administration and reception staff, with online training available to all staff to update their learning when needed.
• Training and Disclosure and Barring Service checks were completed for those staff that undertook the role of chaperone.
• The infection control policy had been updated and improvements evidenced in a recent infection control audit.
• The practice had not completed all the actions of the fire risk assessment. The practice had undertaken some of the required actions and had scheduled works for the outstanding actions, for example the replacement of fire doors and installation of hand rail for the emergency escape route.

• The building had undergone an inspection of electrical installation and wiring this year and was now passed and certified for electrical safety.

There was one area where the provider should make improvement:

• To review the fire recommendations to complete the action plan that has been put in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 March 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.

• 94% of patients with diabetes, on the register, had influenza immunisation in the preceding 1 August 2014 to 31 March 2015.

• 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 29 March 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 accident and emergency 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 showed 82% of women aged 25-64 notes recorded that a cervical screening test had been performed in the preceding 5 years (01/04/2014 to 31/03/2015).

• 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 and health visitors.

Updated 29 March 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 patients in its population.

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

• The practice conducted virtual ward multi-disciplinary team reviews.

• The practice conducted Gold Standard Palliative Care reviews

Updated 29 March 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.

• The practice had extended Hours appointments: Saturday Morning.

• Telephone consultations.

• Same day access for acute problems.

• Smoking cessation clinics in-house.

Updated 29 March 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 dementiahad had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 85%

• 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 29 March 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 patients and those with a learning disability.

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

• 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.