Archived: Thomas Walker Surgery

Updated 17 September 2015

Thomas Walker Surgery is located in Peterborough which is an area of Cambridgeshire. The practice provides services for approximately 7000 patients. The practice holds a General Medical Services contract and provides GP services commissioned by NHS Cambridgeshire and Peterborough Clinical Commissioning Group.

The practice is managed by three full time GP partners (two male, one female) who are supported by clinical staff; two female salaried GPs (one part time, one ¾ time), one female prescribing advanced nurse practitioner, one female practice nurse and two female healthcare assistants. The practice also employs a practice manager and a team of reception, clerical and administrative staff. The practice is a newly appointed training practice for GP trainees and foundation level doctors.

The practice is open from 8.30am to 6.30pm on Tuesday to Friday and on Mondays from 7am to 8am, and then from 8.30am to 7.30pm. Urgent appointments are available on the day. Routine appointments can be pre-booked in advance in person, by telephone or online. Telephone consultations and home visits are available daily as required.

The practice has opted out of providing GP services to patients out of hours such as nights and weekends. During these times GP services are provided currently by the Cambridgeshire & Peterborough CCG commissioned Herts Urgent Care who provide NHS111. They commission Cambridgeshire Community Services to provide the Peterborough GP's Out of Hours Service. When the practice is closed, there is a recorded message giving out of hours’ details.

The practice has a branch surgery at 405a Fulbridge Road, Werrington, Peterborough, Cambridgeshire, PE4 6SE which we did not visit as part of this inspection.

Updated 17 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Thomas Walker Surgery on 13th August 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should :

• Ensure recruitment arrangements include all necessary employment checks for all staff.
• Ensure that staff guidance for administering vaccines and medicines is current and accessible.
• Ensure that Waste disposal containers comply with current infection prevention and control requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 September 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 September 2015

GOOD

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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and community nurses.

Updated 17 September 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice identified patients with caring responsibilities and those who required additional support by recording this on their patient record. The practice used a holistic care approach for all patients aged over 75, where clinicians assessed their health and social care needs.

Updated 17 September 2015

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. Extended hours were offered to ensure working age patients could access the service when required. 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 provided travel advice and vaccination through appointments with the practice nurse team. Information on the various vaccinations was available on the practice website.

Updated 17 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 17 September 2015

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, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and offered longer appointments for those patients.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.