Eynsham Medical Group

Updated 25 August 2016

Eynsham Medical Group provides GP services to more than 13,700 patients in a semi-rural part of west Oxfordshire, in and around the villages of Eynsham and Long Hanborough. The practice serves an older than average patient list, with 24% being aged 65 and above, and fewer than average young adults aged between 20 and 40. The locality has a very low level of deprivation, and serves a mainly White British population.

The practice runs from a main site in Eynsham, and a branch surgery in Long Hanborough. The practice offers dispensary services at both sites, which can provide pharmaceutical services to patients who lived more than one mile (1.6km) from their nearest pharmacy premises. There is also a registered pharmacy at the Long Hanborough surgery.

The practice has eight GP partners, six male and two female, and two female salaried GPs, equivalent in total to 7.5 whole time doctors. It is a training practice, and currently has one GP registrar, and one foundation level trainee doctor. It has five nurses, including one nurse prescriber, and four health care assistants. There are 22 members of administration, reception and support staff, including a practice manager, deputy practice manager and reception manager, and 8 dispensers, including a dispensary manager. The GPs are each based at one of the two surgeries, while most other staff work across the two sites.

Both Eynsham Medical Centre and Long Hanborough Surgery are purpose-built surgeries with all public areas based on the ground floor. They both have adjacent parking, including disabled bays, step free access with automatic entrance doors, and dedicated toilets for patients with disabilities and with baby changing facilities. The waiting rooms at both sites have air conditioning which was funded by the practice’s patient charity.

The practice had a dispensary at the surgeries in Eynsham and Long Hanborough, which could provide pharmaceutical services to patients who lived more than one mile (1.6km) from their nearest pharmacy premises. There is also a registered pharmacy at the Long Hanborough surgery, so all the patients using this practice were able to have their prescriptions dispensed on site.

Both practices are open from 8.30am to 6.30pm Monday to Friday, with GP appointments available between 8.30am and 12.10pm, and from 2.50pm to 6.10pm. A duty doctor was available from 8am to 8.30am daily. The practice also offers extended hours telephone appointments on early Tuesday mornings and Monday, Tuesday and Wednesday evenings

The practice has opted out of providing out of hours services to their patients. The out of hours service is provided by Oxford Health and is accessed by calling NHS 111. Advice on how to access the out of hours service is contained in the practice leaflet, on the patient website and on a recorded message when the practice is closed.

The practice has its own patient charity, the Eynsham and Long Hanborough Medical Care Group which was set up in 1996 to administer gifts received from patients and relatives, as well as additional funds sourced through fundraising activities. It is run by trustees comprising current and former GP partners and patient representatives. The charity supports The charity supports the practice’s twice-weekly prescription home delivery service and the practice website. It has also funded a number of facilities including air conditioning in the waiting rooms at both surgeries, home use blood pressure monitors and electrocardiograms, the defibrillators, and new couches. It also provides small grants to patients in need.

Services are provided from:

Eynsham Medical Centre

Conduit Lane

Eynsham

OX29 4QB

and

Long Hanborough Surgery

56 Churchill Way

Long Hanborough

OX29 8JL

Updated 25 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection Eynsham Medical Group on 22 June 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, 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.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

The practice had designed a “pop up” alert for the records of patients at risk of acute kidney injury to assist with early diagnosis and intervention, and creating a warning card about the risk of dehydration and kidney damage to be given to patients prescribed diuretics. The cards were initially funded by the practice’s patient charity; Oxfordshire Clinical Commissioning Group has now developed and funded a similar scheme with advisory cards, and has used the experience gained by the lead partner in the practice to achieve this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 August 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.

• 88% of patients with diabetes had received a foot examination and risk classification within the preceding 12 months, compared to a CCG average of 90% and a national average of 88%.

• 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.

• The practice had launched an acute kidney injury (AKI) quality improvement project after identifying the role that AKI played in two significant events involving patients on long-term diuretic medicine. The project resulted in the practice introducing innovations to assist with early diagnosis and intervention, and designing a patient information card; the CCG had now developed and funded a similar scheme with advisory cards, and has used the experience gained by the lead partner in the practice to achieve this.

• The practice had run a project to identify patients with atrial fibrillation, who could be at risk of stroke, by checking their pulses while attending flu immunisation clinics. The project had resulted in an increase in flu vaccination uptake in the over 65s from 72% to 84% and young ‘at risk’ patients from 44% to 71%, as well as new identification of four patients with atrial fibrillation.

• More than 200 patients from the practice were currently participating in a national early lung and bowel cancer detection study, representing over 2% of all the volunteers so far recruited.

Updated 25 August 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 A&E 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.

• 84% of female patients aged 25 to 64 had received a cervical screening test in the preceding five years, compared to a CCG average of 83% and a national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We spoke to a health visitor attached to the practice who described effective information sharing and positive joint working.

Updated 25 August 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 people in its population.

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

• The practice promoted local community events relevant to older people. These included a social event in Eynsham to support residents wishing to speak about issues related to end of life and bereavement, and a tea dance in Long Hanborough for people with dementia and their carers. It also promoted local services including a community car scheme to transport patients to appointments, and a "good neighbour" network scheme.

• charity tea dance, a community car scheme to get patients to hospital and clinic appointments and a good neighbour network scheme.’

• Dispensary staff dispensed medicines for some patients in weekly compliance aids to help them manage their medicines safely, and there was a safely managed delivery service funded by the practice’s patient charity for 92 patients who were unable to collect their medicines from the dispensary. The dispensary also provided medicines for patients living in three local care homes.

• We spoke to a district nurse attached to the practice who described effective information sharing and positive joint working.

Updated 25 August 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 including enabling patients to view test results and medical notes as well as book appointments and request repeat prescriptions.
• It also offered a full range of health promotion and screening that reflects the needs for this age group.
• The practice offered early morning and evening GP telephone appointments for patients who could not attend during normal opening hours.

Updated 25 August 2016

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

• 89% of patients with schizophrenia, bipolar affective disorder and other psychoses had their care reviewed in a face to face meeting in the last 12 months, compared to a CCG average of 89% and a national average of 88%.

• 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 advised 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 25 August 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice flagged the notes of patients who were considered to be vulnerable, and held a register of 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.

• The practice gave examples of personalised care for patients with complex needs, which included close liaison with other agencies, and practical support where appropriate, funded by the practice’s patient charity.