Alton Street Surgery

Updated 16 May 2018

Alton Street Surgery is registered with the Care Quality Commission (CQC) as a partnership provider. It is located in the market town of Ross-on-Wye in Herefordshire. The practice holds a General Medical Services (GMS) contract with NHS England. The GMS contract is a contract between general practices and NHS England for delivering primary care services to local communities. At the time of our inspection Alton Street Surgery was providing medical care to 10,630 patients who live within an area of approximately five miles radius from the practice. The practice has a low level of deprivation. The practice has a website which details services and gives information to patients: www.altonstreet.nhs.uk.

The practice provides additional GP services commissioned by Herefordshire Clinical Commissioning Group (CCG). For example, minor surgery. A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

Limited parking is available on site and there is ample parking in the Ross Community Hospital Pay and Display car park nearby. Bus stops are situated on the street outside the practice. There are three parking spaces for disabled patients at the rear of the building and disabled patients can be brought by car to the 'pull-in' adjacent to the front entrance. The practice has facilities for disabled patients.

The practice team consists of three GP partners (two male, one female), four salaried GPs (one male, three female), and a female retainer GP. They are supported by a practice manager, two advanced nurse practitioners, three practice nurses, two health care assistants, a clinical assistant and a reception and administrative team.

Alton Street Surgery is an approved training practice for doctors who wish to become GPs. A trainee GP is a qualified doctor who is training to become a GP through a period of working and training in a practice. Only approved training practices can employ trainee GPs and the practice must have at least one approved GP trainer. At the time of our inspection, there were two trainee GPs. There was also a foundation year two doctor (a doctor in their second year of clinical experience after qualifying as a doctor).

Alton Street Surgery is a teaching practice and provides placements for medical students who have not yet qualified as doctors. There were no medical students at the time of our inspection.

Alton Street Surgery is open from 8am until 6pm on every weekday. Extended hours appointments are provided between 6.30pm and 7.30pm on Mondays, Tuesdays and Wednesdays. The practice is closed at weekends.

Patients can access the out of hours service by using the NHS 111 service. If patients need to see a GP, they are given an appointment at a Primary Care Centre either locally or in Hereford. Home visits are arranged for those patients who are too ill to travel to a Primary Care Centre. Patients can also book appointments with Taurus Healthcare, which provides extended access from 6pm until 8pm during the week and from 8am until 8pm at weekends.

Patients can attend the Minor Injuries Unit at Ross Community Hospital for minor accidents and injuries.

Updated 16 May 2018

This practice is rated as Outstanding overall. (Previous inspection October 2014 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Outstanding

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

We carried out an announced comprehensive inspection at Alton Street Surgery on 21 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear 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.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients said that they found the appointment system straightforward to use and reported that they were able to access care when they needed it. Routine appointments were always available on the same day.
• The GP partners and management team were forward thinking. There was a strong commitment towards development and integrated care.
• The practice was presented with a highly commended award by the Herefordshire Carers’ Association in 2017 in recognition of their work for carers.
• The practice was a hub for community health groups. For example, Herefordshire Carers’ Support and Dementia Action Alliance.
• A self-care station in reception offered practical advice on managing conditions. It enabled patients to be more actively involved in their own self-care programme.
• The practice implemented suggestions for improvements and made changes as a consequence of feedback from patients and from the patient participation group.
• The practice placed a great deal of emphasis on training for trainee GPs, medical students as well as for their own staff.
• The practice was accredited with the Primary Care Clinical Research Network at Warwick University.

We saw an area of outstanding practice:

• The practice took an holistic person centred care approach to people living with mental health issues. For example, a GP chaired the Ross Mental Health and Wellbeing Steering Group, which was instrumental in setting up initiatives such as the Ross Dementia Centre and the GP had developed a poetry support group. Feedback from people using the services identified positive outcomes.

The area where the provider should make improvements is:

• Continue to encourage the uptake of cervical screening.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 May 2018

Updated 16 May 2018

Updated 16 May 2018

Updated 16 May 2018

Updated 16 May 2018

Updated 16 May 2018