Dr S Neill and Partners Also known as Mount Avenue Surgery

Updated 11 May 2016

The practice is known as Mount Avenue Surgery and has been in existence since 1914 and has purpose-built premises built in 1970. It was extended in 1989/90 and again in 1994/95. The Practice area covers Shenfield and Hutton. They have approximately 13,712 patients.

There is limited parking available to patients. The surgery has good access to local parking facilities and public transport. The surgery neighbours Shenfield railway station.

There are currently six partners at the surgery: three work full time and three work part time. Three of the GPs are female. They are supported by an extensive nursing team of six registered general nurses and an administrative/reception team, medical secretaries, dedicated prescription team overseen by deputy managers and the practice manager.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8.30am to 11.30am and 2pm to 5.30pm daily. Extended hours appointments are offered on Saturday mornings from 8.30am to 11.45am. These are pre-bookable appointments, available up to seven days in advance with the GP or nurses.

The practice serves an aging population with higher representation amongst their patients over 65years than nationally. Both male and female patients have a higher life expectancy than the local and national averages.

The practice has a clear and comprehensive website providing patients with a menu of options how they may contact the surgery, access to additional health services and information sites.

Updated 11 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr P Ward and Partners (also referred to as Mount Avenue Surgery) on 20 April 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, recording investigating and responding to significant events.
• Lessons were shared amongst the practice team to make sure action was taken to improve safety in the practice. However, where actions were assigned and reviewed the date of completion was not consistently recorded.
• Medical safety alert information was actioned, reviewed and overseen by a lead GP.
• Risks to patients were assessed and well managed through annual risk assessments and audits.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment to undertake their roles and responsibilities .
• Patients said the staff cared and they were consistently treated with compassion, dignity and respect. They were involved in their care and decisions about their treatment.
• There was a high rate of non-attendance by patients for appointments and some patients reported difficulties making an appointment. The practice consistently reviewed the accessibility of their service and ensured urgent appointments and home visits were available the same day.
• Information about services and how to complain was available and easy to understand. Complaints were thoroughly investigated in a timely and transparent manner. Improvements were made to the quality of care as a result of complaints and concerns.
• 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 the partners, practice manager and their colleagues.
• The practice welcomed and valued feedback from staff and patients, which it discussed with them and acted on.

The areas where the provider should

• Ensure where actions are assigned after the analysis of significant events, these are reviewed and completion dates are documented.
• Regularly check the battery for the defibrillator to ensure it is charged.
• Revisit the findings of clinical audits to confirm patients are receiving appropriate monitoring.

• Document their business plan so there is a clear written strategy for the future.

• Improve the identification of carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 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.
• Patients at risk of hospital admission were identified as a priority.
• 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.
• The practice participated in the admission avoidance programme ensuring care plans were in place and reviewed them regularly.

Updated 11 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.
• 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice participates in child health surveillance.

Updated 11 May 2016

The practice is rated as good for the care of older people.

• The practice offered 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 practice conducted regular multidisciplinary meetings with partner health and social care services.
• The practice nurses promoted and provided flu vaccinations.

Updated 11 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 had been identified.
• The practice regularly reviewed their appointment system and adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice offered a range of appointments of that could be accessed by reception, online services, telephone appointments.
• The practice offers a full range of health promotion and screening that reflects the needs for this age group. With nationally comparable screening rates in breast and bowel cancer.

Updated 11 May 2016

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

• The practice achieved above the national average for their management of patients with poor mental health.
• Patients diagnosed with dementia had their care reviewed in a face to face meeting.
• 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 told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 11 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 those with a learning disability. They conducted annual health reviews for patients with learning disabilities and monitored attendance.
• The practice offered longer appointments for patients 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.
• 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.