Testvale Surgery Also known as Dr Entwisle and Partners

Updated 6 September 2016

Testvale Surgery is located in a purpose built detached property at 12 Salisbury Road, Totton, Southampton, Hampshire, SO40 3PY.

Testvale Surgery has an NHS Personal Medical Services contract to provide health services to approximately 13000 patients in and around the Totton area of Southampton. The practice covers a mixed urban rural population and has 1324 patients over the age of 75 years. This practice has been a training practice since 1988.

The practice has seven GP partners, three male and four female, two female salaried GPs and at the time of the inspection two registrar doctors. The practice has a nurse practitioner, three practice nurses and two healthcare assistants. The clinical team are supported by a practice manager, IT manager, website manager, reception supervisor and a team of 12 receptionists, typist and administration support staff.

The practice is open Monday to Friday 8am to 6:30pm and operates extended hours clinics on certain days. The practice reception opens at 8am and closes at 6:30pm Monday to Friday. The reception is closed on weekends and on public holidays. The practice has early morning appointments from 7.30am three days a week and late appointments until 7.30pm one day a week. They have a walk-in service for emergencies and injuries and unlimited telephone access.

Phone lines are open from 8am to 6.30pm Monday to Friday (excluding public holidays); the appointments line is closed from 1pm to 2pm Monday to Friday. The practice website also gives full details of times individual GPs are available for appointments.

Same day appointments can be booked at any time from 8am on the day the patients needed the appointment for.

There is an automated telephone system giving the available options to help patients get through to the correct department directly. Calls come in they are put into a queuing system until there is a member of staff available to take the call.

The practice offered telephone consultation appointments with the GP or nurses which could be arranged via the reception team. The practice also offered home visits if required and appointments with the practice nurses if the patient felt they did not need to speak with a GP.

Urgent appointments were also available for people who needed them. Routine appointments could be made well in advance usually up to four weeks in advance.

Appointments could be made by phone, on line or by visiting the practice. The practice offered online booking of appointments and requesting prescriptions.

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 6 September 2016

Letter from the Chief Inspector of General Practice

We carried out a follow up inspection of Testvale Surgery on 4 August 2016 to check that action had been taken since our previous inspection in January 2016.

In January 2016 the practice was rated as overall good.The practice was good for effective, caring, responsive and well led services.

However we found that the practice required improvement in the safe domain due to breaches of regulations relating to safe delivery of services.

We found that the practice had not ensured that they had assessed monitored, managed and mitigated risks to the health and safety of service users. This was in relation to health and safety risk assessments, maintenance and checking of a defibrillator, Legionella assessments, equipment calibration and premises electrical testing.

We inspected the practice on 4 August 2016 to check that they had followed the action plan they had submitted and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection for Testvale Surgery on our website at www.cqc.org.uk

Our key findings for this review were as follows:

The provider had made improvements:

• The practice reviewed its water safety risk assessment in relation to Legionella to ensure that the water supply did not pose a risk to patients, visitors or staff.
• The practice had undertaken health and safety risks assessments and were working through action plans relating to improvements in that area.
• The practice had completed calibration of equipment and premises electrical testing.
• The maintenance and checking of a defibrillator had been updated and appropriate checks were completed.

The practice is now rated good for safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 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.

• 97% of patients with diabetes had received influenza immunisation in the preceding 1 August 2014 to 31 March 2015. The national average was 95%.
• 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 31 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.

• 66% of patients diagnosed with asthma, on the register, had an asthma review in the last 12 months. This was lower than the national average.

• 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 was comparable to national averages for the percentage of women aged 25-64 who had had a cervical screen test in the last five years. The practice percentage was 80%, compared to the national average 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 and health visitors.

Updated 31 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 had access to a care navigator who supported patients aged 75+ with long term conditions and their carers to access timely care and community support services.

Updated 31 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 early morning appointments from 7.30am three days a week and late appointments until 7.30pm one day a week.

The practice had a walk-in service for emergencies and injuries and unlimited telephone access.

Updated 31 March 2016

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

• 84% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months, which is above the national average of 89%.

• 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 31 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, travellers 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.