Springfield Surgery

Updated 23 May 2016

Springfield Surgery is located in the village of Elstead, five miles from the nearest town of Godalming. The practice covers a semi-rural area, and transport links from the village are limited. The surgery is all on ground floor level. The practice operates from:

Springfield

Elstead

Godalming

GU8 6EG

There are approximately 3,900 patients registered at the practice. Statistics show very little income deprivation among the registered population. The registered population is lower than average for 10-39 year olds and higher than average for those aged 45 and above. The practice has a very high proportion of elderly patients with 13.7% of the population over 75 (national average 7.8%) and 4.6% over 85 (national average 2.3%). There are fewer patients of working age than the national average (49% compared to 62%) and a higher proportion of adults with a long standing health condition (59% compared to national average of 54%).

The practice has two partners and one salaried GP (one male and two female). One of the doctors works full time and the other two work part time. There are three practice nurses and one health care assistant who all work part time. There are eight part time receptionists led by a practice manager.

The practice is open from 8am to 6.30pm from Monday to Friday. Appointments are from 8.10am to 11.30am and 3pm to 6pm. Patients can book appointments in person, by phone or on line. Telephone lines are open from 8am to 6.30pm.

Patients requiring a GP outside of normal working hours are advised to contact the NHS GP out of hours service on telephone number 111.

The practice has a General Medical Services (GMS) contract. GMS contracts are nationally agreed between the General Medical Council and NHS England.

Updated 23 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Springfield Surgery on 17 March 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 the majority of risks were well managed.
• The practice was part of a local frailty initiative to provide care and support for frail patients.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care was consistently and strongly positive.
• 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.
• There was an active patient participation group who organised health education events.
• 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.

The areas where the provider should make improvement are:

• Ensure that regular fire alarm checks continue to be carried out and documented, and ensure that fire drills are carried out as planned and documented.
• Ensure the infection control audit is reviewed once completed and ensure any actions identified are noted with a timescale for completion.
• Review how patients on the diabetic register are cared for and monitored to ensure they are getting the regular checks required for managing their condition as outlined in the Quality and Outcomes Framework (QOF).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 May 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.
• 76% of patients on the diabetes register had a record of a foot examination and classification which was below the national average of 88%. The percentage of patients with diabetes, on the register, in whom the last blood pressure was 140/80 mmHg or less was 70%, which was below the national average of 78%. The practice were reviewing their approach to managing diabetes as their lead nurse for diabetes had recently left the practice.
• 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 23 May 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.
• 70% of patients with asthma, on the register, had an asthma review in the preceding 12 months compared to a national average of 75%
• 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.
• 79% of eligible female patients had a cervical screening test which was slightly below 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.
• The practice provided rapid access to patients, including those who had minor injuries, providing a valuable service to local people.

Updated 23 May 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 patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice participated in a local frailty initiative to prevent admission to hospital. This involved attending local multidisciplinary team meetings with social care and the geriatrician to plan the care needed for frail people.
• The doctor contacted patients who had been discharged from hospital following an emergency admission to ensure they had the medical support they needed.
• The practice carried out weekly visits at three care homes for older people and feedback from the homes was mixed. One home highly praised the service received from the doctor and the administrative support whilst another raised concerns over the timing of the visits.
• The practice worked closely with the community matron and held regular review meetings for frail patients.
• The practice facilitated reviews with the pharmacist for patients taking a lot of different medicines.

Updated 23 May 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 for booking appointments and ordering repeat prescriptions, as well as a full range of health promotion and screening that reflects the needs for this age group.
• Electronic prescribing allowed prescriptions to be sent to a pharmacy near to the workplace.

Updated 23 May 2016

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

• 89% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 84%.
• 87% of patients experiencing poor mental health had an agreed care plan, which is in line with the 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 had good working relationships with the community mental health teams including dementia community psychiatric nurses.
• 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 23 May 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.