Archived: Westside Surgery

Updated 24 January 2018

Westside Surgery is located in Boston, Lincolnshire and delivers regulated activities from Westside Surgery only. Services provided by the practice are commissioned by Lincolnshire East Clinical Commissioning Group (LECCG).

The practice is registered with the Care Quality Commission (CQC) as a partnership provider and holds a General Medical Services (GMS) contract with NHS England and provides a number of enhanced services to include minor surgery. A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.

The practice treats patients of all ages and provides a range of medical services. There are currently around 10,280 registered patients at the practice. The practice local area has pockets of deprivation and a transient population which swells in the summer due to the influx of temporary agricultural workers. The practice has a slightly higher percentage of patients aged 18 and under, and a slightly lower percentage of patients aged 65 and over compared to the national averages. The practice has 57% of patients with a long-standing health condition compared to the CCG average of 61% and the national average of 53%. The practice has a high percentage of Eastern European foreign nationals as patients, mainly Polish, which fluctuates during the year but is approximately 16% of the patient list.

The practice operates from a purpose built, privately owned building shared with another GP Practice. The practice is owned and managed by a team of four GP partners who are supported by locum GPs, an advanced nurse practitioner (ANP), a clinical associate, four practice nurses, three healthcare assistants, an administration team and a management team. The practice had a GP registrar working and training under the supervision of the senior GP. Opening hours are between 8am and 6.30pm Monday to Friday. Extended hours appointments are available on Monday and Thursday evenings from 6.30pm to 8pm aimed at, but not exclusively for patients who would otherwise find it difficult to attend the practice during the day due to work or unforeseen circumstances.

The practice is an approved training practice for the training of General Practice Registrars and medical students; and currently has one trainee GP. The practice is registered with a local university and works with them on research projects which aim to improve future patient care. The practice is also a member of the Community Educators Providers Network (CEPN) and provides placements for undergraduate medical students and nursing students. In addition, work experience placements are provided to non-clinical staff and the practice participates in an apprenticeship scheme.

Additional information about the practice is available on their website: www.westsidesurgery.uk

Updated 24 January 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Requires Improvement overall. We previously carried out an announced comprehensive inspection on 30 November 2016; the practice was rated inadequate, with the safe, effective and well-led key questions rates as inadequate. The practice was rated as requires improvement in responsive and good in caring. We found three breaches of the legal requirements and as a result we issued a warning notice in relation to:

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Safe Care and Treatment.

• Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Good Governance.

In addition, we issued a requirement notice in relation to:

• Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Fit and Proper Persons Employed.

Following that inspection, the practice was placed in special measures.

We carried out an announced comprehensive inspection at Westside Surgery on 15 November 2017 to monitor that the necessary improvements had been made.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Requires Improvement

Are services responsive? – Requires Improvement

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The practice overall rating was requires improvement and this related to patients in each of the population groups:

Older People – Requires Improvement

People with long-term conditions – Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those recently retired and students) – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

People experiencing poor mental health (including people with dementia) - Requires Improvement

At this inspection we found:

• The practice had systems, processes and practices in place to protect people from potential abuse. Staff were aware of how to raise a safeguarding concern and had access to internal leads and contacts for external safeguarding agencies.
• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• There were systems in place for identifying, assessing and mitigating risks to the health and safety of patients and staff.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• The partners had reviewed and increased its workforce and employed additional clinicians with a varied skill mix to help meet the health and social needs of patients and the demand for access to appointments.
• Staff had received essential training to enable them to carry out their duties safely.
• We saw that staff involved and treated patients with compassion, kindness, dignity and respect. However, the national patient survey highlighted that patient satisfaction scores were below local and national averages when asked about their feedback on GP consultations.
• Patient feedback on same day access to appointments was positive. However, some patients found it difficult to access the practice by telephone.
• The practice had suitable facilities was well equipped and maintained to treat patients and meet their needs.
• The practice worked proactively with the patient participation group (PPG) to meet the needs of their patients and had consulted with them and members of the community about a planned merger with a neighbouring GP practice based in the same building.
• There was a focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Consider how exception reporting can be reduced or better recorded to increase assurance that treatment given away from the practice has been appropriate and effective.
• Take steps to improve the uptake of health checks for those patients over 75 years.
• Explore how the patient satisfaction scores in relation to consultations with a GP from the National Patient Survey can be improved.
• Improve the complaints management by recording discussions held in practice meetings and updating the contact details on the practice website.
• GPs to adopt all policies including those relating to administration.
• Further follow good practice guidance and adopt control measures to make sure the risks to patients, staff and visitors are minimised.

I have taken this practice out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 January 2018

Updated 24 January 2018

Updated 24 January 2018

Updated 24 January 2018

Updated 24 January 2018

Updated 24 January 2018