New Court Surgery

Updated 13 July 2016

New Court Surgery started as a new practice in the town of Royal Wotton Bassett in 1973 and moved to new premises in 1991, which have since been extended. The practice serves a population of approximately 10,000 patients in an area with little social deprivation. The practice demographics are similar to the national average except for slightly lower than average number of patients between the ages of 20 to 40.

The practice is a teaching and training practice and supports GP Registrars (Registrars are qualified doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine) as well as medical students and nursing students.

The practice team consists of four GP partners, two salaried GPs (three male and three female) and currently has two GP trainees. The GPs are supported by a team of six nursing staff including one nurse non-medical prescriber, two health care assistants and a care coordinator (who also does one session as a health care assistant). The practice team is supported by a practice manager and a team of reception and administration staff.

The practice is open between 8am and 6.30pm Monday to Friday.The practice opens early on Tuesday and Thursday mornings at 7.15am. The surgery has evening appointments until 8pm on Wednesdays. Core appointments are variable from 8am to 12pm and 2.30pm to 6pm with extended hours appointments from 7.15 am and until 8pm during the extended hours periods. In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments were also available for people that needed them.

When the surgery is closed the out of hour’s service is provided by MEDVIVO, accessed via NHS 111.

The registered activities the practice provides are available at the following location:

New Court Surgery

Borough Fields

Royal Wotton Bassett

SN4 7AX

Updated 13 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Court Surgery on 2 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 July 2016

The practice is rated as good for the care of patients 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 practice ran specialised multi-morbidity clinics to review ongoing conditions, assess any changes and review medicines and treatments to ensure optimum care and also to try to prevent any unnecessary hospital admissions.

• Longer appointments were standard as the surgery recognised this as providing higher quality consultations and support for those with complex needs and long term conditions.

• The practice reviewed the requirements for home visits every lunchtime and home visits were available when needed.

• Performance for diabetes related indicators were mixed compared to local and national averages, for example:

• The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015) was 91% which was in line with the clinical commissioning group (CCG) average of 91% and the national average of 88%.

• The percentage of patients with diabetes, on the register, who have had influenza immunisation in the preceding 1 August to 31 March (01/04/2014 to 31/03/2015) was 86% which was lower than the CCG average of 96% and the national average of 94%.

• All of 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 13 July 2016

The practice is rated as good for the care of families, children and young patients.

• 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.

• The practice sent an information pack to all teenagers on their 13 birthday with information on services available and confidentiality.

• 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.

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

• Any young adults who needed sexual health advice and support could be seen and/or referred to the ‘no worries’ service for confidential advice and care without a prior appointment.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 13 July 2016

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

• 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 a care coordinator to support older patients with care and support services including home assessments and memory assessments.

• The practice had developed an educational leaflet to support patients to understand and be able to discuss decisions about do not resuscitate orders; this had been shared across the CCG.

• The practice ran educational and health promotion events for the community in collaboration with the care coordinator and the Friends of New Court Surgery, which provided health education and support for the community and particularly for any older socially isolated patients.

Updated 13 July 2016

The practice is rated as good for the care of working-age patients (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 offered a wide range of telephone appointments as well as early and late appointments for the needs of this group.

Updated 13 July 2016

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

• Performance for mental health related indicators were higher than local and national averages, for example:

• The percentage of patients with a serious mental health problem who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 100% which was higher than the CCG average of 93% and the national average of 88%.

• The percentage of patients with a serious mental health problem whose alcohol consumption has been recorded in the preceding 12 months (2014/15) was 98% which was higher than the CCG average of 93% and the national average of 90%.

• The percentage of patients diagnosed with dementia whose care has been reviewed in a face-to-face review in the preceding 12 months (2014/15) was 100% which was higher than the CCG average of 88% and the national average of 84%.

• The practice was a dementia friendly practice and was supporting the town to become a dementia friendly town.

• 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 Friends of New Court Surgery had funded a counsellor for the last 16 years to support the patients.

• 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 13 July 2016

The practice is rated as good for the care of patients 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.

• The practice was a safe haven place for anyone whether registered or not who needed a safe place to come to.

• The practice offered early or late appointments in quieter times for those with any anxiety issues, and/or a quiet waiting area if required.

• The practice offered longer appointments for patients with a learning disability and had adjusted the health check format to provide a more individual health check for patients.

• 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.