Virginia Water Medical Practice

Updated 25 July 2017

Packers is a long standing family practice which is located on the Wentworth Estate, at the end of a parade of shops in Virginia Water. It is sometimes known as Virginia Water

Medical Practice. The building was purpose built in 1975, originally with an accommodation suite above the practice rooms. The downstairs has two consulting rooms, a reception and waiting area and offices used by administration staff. There is a treatment room on the first floor which is accessed via a separate staircase, with a separate waiting room. There is no lift and no room to install a lift, the building has limited scope for any further development. The practice is considering plans to extend the premises to meet increasing patient demand.

The surgery is located at:

Christchurch Road

Virginia Water

Surrey

GU25 4RL

There are approximately 4,820 patients registered at the practice. Statistics show very little income deprivation among the registered population. The registered population is lower than average for 15-34 year olds and higher than average for those aged 45-59 and 80 and over. There is a lower proportion of adults with a long standing health condition (43% compared to national average of 54%).

The practice has two partners (one male and one female), both doctors work full time. There is a practice nurse and a health care assistant. The practice manager leads an administration and reception team of eight staff.

The practice is open from 8am to 6.30pm from Monday to Friday. Appointments and open surgery take place between 8am and 12.15pm and 2.30pm to 6pm. Telephone lines are open from 8am to 6.30pm, with urgent calls only answered between 1pm and 2pm by the practice.

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

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

Updated 25 July 2017

Letter from the Chief Inspector of General Practice

Our previous focused inspection at Packers on 7 June 2016 found breaches of regulation relating to the safe delivery of services. The overall rating for the practice was good. Specifically, we found the practice to require improvement for provision of safe service. It was good for providing effective, caring, responsive and well led services. Consequently we rated all population groups as good. The previous inspection reports can be found by selecting the ‘all reports’ link for Packers on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 21 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 7 June 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the practice had made improvements since our last inspection. At our inspection on the 21 June 2017 we found the practice was meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the practice is rated as good.

Our key findings were as follows:

• The practice had demonstrated improvement and all the areas of concerns from the previous inspection had been resolved.
• The practice had carried out remedial work to ensure fire safety in the premises.
• All staff had undertaken the fire safety awareness training.
• A satisfactory electrical installation condition report was issued in June 2017.
• We found the practice was not carrying out water temperature checks in the premises. However, the practice had responded proactively and informed us a day after the inspection that they had taken urgent steps to ensure the effective management of legionella. (Legionella is a term for a particular bacterium which can contaminate water systems in buildings).
• The practice had introduced effective monitoring system to ensure that accurate training records were kept of all training undertaken by staff.
• We saw evidence that the practice held monthly clinical team meetings and practice team meetings. We saw minutes were kept of all meetings to aid learning and information sharing.
• The practice had demonstrated improvement in governance arrangements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 August 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.
• 90% of patients on the diabetes register had a record of a foot examination and classification which was in line with the CCG average of 89% and national average of 88%.
• 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 August 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.
• 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.
• 80% of eligible female patients had a cervical screening test which was similar to the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Childhood immunisation rates for the vaccines given were in line with or better than clinical commissioning group (CCG) averages.

Updated 23 August 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 people, and offered home visits and urgent appointments for those with enhanced needs.
• The GPs regularly visited residents at a local care home every week and feedback from the home was very positive. There were over 70 residents at the home which had a unit for people with dementia and an assisted living unit.
• The practice identified those patients most at risk of hospital admission. A care coordinator rang these patients after a discharge from hospital to offer assistance and support.

Updated 23 August 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• 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 electronic prescribing allowing patients to collect prescriptions from a pharmacy closer to their place of work.
• Appointments were available on Saturday mornings for patients who could not attend on a weekday, and telephone appointments were available during the day.
• 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.

Updated 23 August 2016

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

• 91% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average of 84%.
• 95% of patients experiencing poor mental health had an agreed care plan, which was better than 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 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 August 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 people, travellers and those with a learning disability.
• Practice staff understood the cultural needs of the local traveller population and how to achieve good medical care for this group of patients.
• The practice offered longer appointments for patients with a learning disability and saw these patients outside routine surgery hours when the waiting room was quiet. They looked after a home for residents with a learning disability.
• 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.