Bishops Waltham Surgery

Updated 29 November 2016

Bishops Waltham Surgery is located at Lower Lane, Bishops Waltham, SO32 1GR.

The practice has an NHS Personal Medical Services contract to provide health services to approximately 12800 patients in and around the villages of practice area including; Bishops Waltham, West Meon in the North, Droxford in the East, Wickham in the South and Colden Common in the West.

The practice population come from a relatively affluent area with a higher than the national average for patients in the 45 to 70 years old age groups for both male and females. The practice is located in a detached property and has a small car park at the front. The practice has disabled car parking and disabled access to the practice. All the consulting and treatment rooms are located on the ground floor of the practice. The practice has a compact waiting room with a reception desk and dispensary counter.

The practice has a dispensary; this allows the practice to dispense to those patients who live more than a mile away from a pharmacy and to those patients that may require an urgent prescription after the pharmacy has closed.

The practice has eight GP partners, four male and four female, offering 48 sessions per week, two GP Registrars, a Nurse Practitioner working within the practice. Additionally there are two practice nurses and two health care assistants. The GPs and the nursing staff are supported by a practice manager, a dispensary manager and a team of staff who carry out dispensary, administration, reception, scanning documents and secretarial duties.

The practice has had a longstanding commitment to training. All staff are involved and we saw there was open door policy to ask questions, seek advice or to share information which received positive feedback from doctors undergoing training.

The practice is open Monday: 7.30am to 7.15pm, Tuesday: 8am to 6.30pm (closed 1pm to 2pm), Wednesday: 07.30am to 6.30pm, Thursday: 8am to 6.30pm, Friday: 7.30am to 6.30pm. Appointments are divided into routine pre-bookable appointments which are available up to six weeks in advance, 48 hour routine appointments and ‘Urgent’ same day appointments. Appointment reminders as text messages are sent via the practice computer system when an appointment is booked and another two working days before appointment (where permission has been given).

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.

The practice provides regulated activities from a single location at Bishops Waltham Surgery, Lower Lane, Bishops Waltham, Southampton, Hampshire. SO32 1GR. We visited this location during our inspection.

Updated 29 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at the Bishops Waltham Surgery on 20 September 2016. This was to review the actions taken by the provider as a result of our issuing a legal requirement. In December 2015 the practice did not have safe systems in place for the safe management of risks relating to health and safety, infection control and procedures in place for the reporting of safeguarding events.

Overall the practice has been rated as Good following our findings, with safe now rated as good. This report should be read in conjunction with our report published on 17 March 2016 where the effective, responsive and caring and well led domains were rated as Good. This can be done by selecting the 'all reports' link for Bishops Waltham Surgery on our website at www.cqc.org.uk

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

• We found the practice had identified a staff member as an infection control lead, they had undertaken training in infection control and undertaken an audit to improve patient outcomes.

• A full health and safety risk assessment of the practice had been carried out.

• Policies and procedures governing health and safety, including adult safeguarding had been reviewed and updated.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 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.

• The percentage of patients with diabetes, on the register, who had received influenza immunisation in the preceding 1 August 2014 to 31 March 2015 at 96%, was comparable to other practices and the national average at 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 17 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 percentage of women aged 25-64 who had had a cervical screening test in the preceding five years at 81% was comparable to 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 and health visitors.

Updated 17 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.

Updated 17 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.

Updated 17 March 2016

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

• 78% of patients diagnosed with dementia that had had their care reviewed in a face to face meeting in the last 12 months, which was below the 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 17 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.