Archived: Eldon Road Surgery

Updated 10 May 2017

Eldon Road Surgery is located close to the centre of Reading. It occupies a large building which was not designed for the delivery of medical services. The practice opened in 2001 when one GP took over the premises from a sports clinic. Since opening the practice has grown from around 400 patients to serving a registered population of approximately 2,800. There is limited parking available to patients and due to the nature of the premises, access for patients with a disability is limited. Most patients live close to the practice and either use public transport or walk to the practice. Public transport services in the area are frequent due to the town centre location. Approximately 35% of the practice population are from ethnic minority groups and income deprivation is recognised as an issue.

There are three GPs working at the practice. Two male partners and a female salaried GP who works one morning each week. They are equivalent to 1.4 whole time GPs. The practice employs a part time practice nurse who works on four days each week. A health care assistant (HCA) works part time on the days and sessions when the practice nurse is not present. The GPs and practice nurses are supported by a part time practice manager and a team of five administration and reception staff. The local midwife attends the practice once a week. There is a monthly visit from a chiropody service funded by the practice for patients aged over 65 and those with long term conditions that benefit from this provision.

The practice is open between 8am and 6.30pm every weekday. Appointments are from 8.30am to 12.30pm in the morning and afternoon clinics commence at 2.30pm until 5.45pm every weekday. Extended hours clinics are offered on a Monday morning from 7.30am and on a Wednesday evening until 7.30pm.

The practice has opted out of providing out of hours services to their patients. Out of hours services are provided by Westcall. The out of hours service is accessed by calling 111. There are arrangements in place for services to be provided when the surgery is closed and these are displayed at the practice and in the practice information leaflet.

All services are provided from: Eldon Road Surgery, 10 Eldon Road, Reading, Berkshire, RG1 4DH.

On 1 April 2017 the practice formalised a partnership that had been in place for three years. The practice had commenced applications to vary the registration to a partnership and appoint a registered manager. However, at the time of inspection the practice remained registered to an individual, Dr Narayan.

Updated 10 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive follow up inspection at Eldon Road Surgery on 19 August 2016. The overall rating for the practice was good but requires improvement for provision of effective services because we identified a breach of regulation. The breach of regulation relating to effective provision of services had also led to a rating of requires improvement for two population groups, people with long term conditions and people experiencing poor mental health (including people with dementia). The full report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Eldon Road Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 April 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 19 August 2016. This report covers our findings in relation to that requirement and also additional improvements made since our last inspection.

Overall the practice remains rated as good and we have updated the rating for provision of effective services to good.

Our key findings were as follows:

• Outcomes for people with long term conditions were similar to both local and national averages from the previous year.
• There had been an increase in screening rates for both cervical and breast cancer.
• Care plans had been updated to ensure those patients that needed such plans had them in place. Care plans were agreed with the patient.
• Audits had been undertaken to ensure that patients with long term medical conditions were called for regular reviews. For example, audit of medicines used in the care of patients with diabetes had taken place resulting in an increase of 14 patients on the diabetes recall programme.
• The practice had increased GP availability from 1.1 whole time GPs to 1.4 thus giving better access to GP appointments.
• There was a sharper focus on improving the health of patients and promoting healthy lifestyles.

We saw one area of outstanding practice:

• Care plans for patients whose first language was not English had been translated into Nepalese and Hindi. Patients were given a copy of their plan. The translation assisted them and their relatives or carers to follow the agreed actions. Approximately 35% of patients registered at the practice were identified from ethnic groups other than white British.

At our previous inspection on 19 August 2016, we rated the practice as requires improvement for providing effective services as the practice had breached the regulation relating to safe care and treatment. At this inspection we found that sufficient improvement had been achieved to update the rating for provision of effective services to good. The practice had addressed the breach of regulation and was now compliant with all regulations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 May 2017

The provider had resolved the concerns for provision of effective services identified at our inspection on 19 August 2017 which applied to everyone using this practice, including this population group. This population group rating has been updated to reflect this.

Updated 13 October 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 patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Cervical cancer screening rates had improved by 7% in six months. The practice had achieved a screening rate of 78% (rising from 71%) compared to the national average from the previous year of 82%. Cervical screening information leaflets were provided in languages other than English to assist patients whose first language was not English.

• 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 13 October 2016

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

• There were 41 patients registered with the practice aged over 75.

• 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.

• A visiting NHS chiropody service was available for patients aged over 65.

Updated 13 October 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.

• Extended hours clinics were held on two evenings every week until 7.30pm. On one evening the extended hours clinic included practice nurse appointments until 7pm.

• The practice had introduced a website that enabled online appointment booking and requesting repeat prescriptions.

Updated 10 May 2017

The provider had resolved the concerns for provision of effective services identified at our inspection on 19 August 2017 which applied to everyone using this practice, including this population group. This population group rating has been updated to reflect this.

Updated 13 October 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 people and those with a learning disability.

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

• The practice regularly worked with other health care professionals 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.