Upton Surgery

Updated 5 April 2018

Upton Surgery provides care for approximately 10,949 patients. The service covers Upton upon Severn and 15 surrounding rural villages within an area of 70 square miles. The practice holds a General Medical Services contract, a nationally agreed contract. The practice was able to offer dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy.

There was a higher than average patient age of 45 to 85+ years of both sexes registered at the practice. There was lower than average population group of age 0 to 44 years of both sexes.

The practice provides care for 100 patients who are aged 90 years or over and 177 registered patients who reside in six nursing and care homes. Patients in care homes have a designated GP who visits weekly. The lead nurse for older people also visits these patients.

The premises were purpose built with all consulting rooms located on the ground level for ease of access for patients who have limited mobility. There is a dedicated car park and some spaces are allocated for disabled patients.

The practice has six GP partners and one salaried GP. GPs are supported by two advanced nurse practitioners (prescribers) who between them spend 65.5 hours seeing patients with minor ailments. There are four practice nurses (one was the lead for older patients and a prescriber) and four health care assistants (HCAs) who provide cervical screening, vaccinations, reviews of long term conditions and phlebotomy (taking blood samples) services. There is also a full time phlebotomist. A full time pharmacist has taken the role of practice manager but continues to oversee the dispensary and provide advice to GPs and advanced nurse practitioners. The practice employs a practice director (manager) who has a personal assistant, and an assistant practice manager. They are supported by administration staff, a senior administrator, an administrator and an administrator/receptionist. There are seven receptionists, one business administrator and a medical secretary. There is a dispensary team leader, seven dispensers, three dispenser assistants and two drivers.

The practice is a designated training practice for trainee GPs. These are qualified doctors who are learning the role of a GP. Clinical staff also provide training for medical students from Warwick Medical School.

The practice offers a range of clinics for chronic disease management, diabetes, chronic obstructive pulmonary disease (COPD) heart disease, asthma, cervical screening, contraception advice, minor surgery, anticoagulation, injections and vaccinations. The practice is open from 8am until 6.30pm every weekday.

The practice offers a range of services. For example, management of long term conditions such as diabetes, contraceptive advice, immunisations for children, travel vaccinations, wound management, podiatry, chiropractor, retinal and aneurysm screening. Further details can be found by accessing the practice’s website at www.uptondoctors.co.uk

Updated 5 April 2018

We carried out an announced comprehensive inspection at Upton Surgery on 13 February 2018 as part of our inspection programme.

At this inspection we found:

• The practice had comprehensive systems in place to manage and monitor risks to patients, staff and visitors. This included risks to the building, environment, medicines management, staffing, equipment and a range of emergencies that might affect operation.

• The practice continued to achieve 100% on the Quality Outcomes Framework and had an overall low exception reporting rate.

• The practice routinely reviewed the quality and effectiveness of the care it provided. Care and treatment was delivered according to evidence based guidelines. We saw that a wide range of clinical audits were carried out and there was a whole practice approach to improvement.

• The leadership, governance and culture were used to drive and improve the delivery of its service. All staff were involved in the development of the practice and were proud of their achievements.

• The practice reviewed the needs of their local population and had initiated positive services for patients.

• Staff treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• Services were tailored to meet the needs of individual people and were delivered in a way that ensured flexibility and choice. For example, Saturday appointments improved access for patients who were unable to attend appointments during working hours.

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. There was a strong focus on continuous learning and improvements at all levels in the practice. When incidents did happen, the practice learned from them and improved their processes.

• There was evidence that service improvement was a priority among staff and leaders. High standards were promoted by all practice staff and there was strong team working and a commitment to personal and professional development.

We saw several areas of outstanding practice:-

• The practice was forward thinking to improve the outcomes for patients in the area. There was a clear approach to seeking out and integrating services to improve patient care. It sought out opportunities to engage with the community and provide a range of accessible services to meet the needs of its population.

• The practice understood the rurality and challenges of its practice population and developed a strategy to build responsive services in line with health and social care priorities across the region. There was a clear vision and set of values. The practice had a realistic strategy and supporting business plans to achieve priorities. Strategies and plans were aligned in the wider health economy and there was a demonstrated commitment to a system wide collaboration and leadership.

• There was clear, inclusive and effective leadership at all levels. Leaders demonstrated the high levels of experience, capacity and capability needed to deliver sustainable care. There were deeply embedded systems of leadership which aimed to ensure that senior staff had considered the needs for the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 April 2018

Updated 5 April 2018

Updated 5 April 2018

Updated 5 April 2018

Updated 5 April 2018

Updated 5 April 2018