Archived: Springcliffe Surgery

Updated 2 June 2016

Springcliffe Surgery provides primary medical services to a population of 2,471 registered patients in the City of Lincoln. The surgery has three consultation rooms on the ground floor. The practice can be accessed by people who have reduced mobility with ramped access at the back of the practice.

• All services are provided from: Springcliffe Surgery, 42 St Catherines, Lincoln. LN5 8LZ

• The practice comprises of three GP Partners (female), one salaried GP (male),

• The all female nursing team consists of three advanced nurse practitioners, five practice nurses, a phlebotomist and a health care assistant.

• A practice manager, assistant practice manager and a team of 13 reception and administrative staff undertake the day to day management and running of the practice.

• The practice has core opening hours between 8am and 6.30pm every weekday. The practice does not provide extended hours surgeries.

• There are appointments that can be booked in advance with GPs or nurses and appointments on the day are triaged.

• The advanced nurse practitioners (ANPs) receive all on the day appointments and home visit requests and ANPs allocate home visit requests to ANPs, GPs or Nurses, as appropriate.

• The practice opted out of providing the out-of-hours service. This service is provided by the out-of-hours service accessed via the NHS 111 service. Advice on how to access the out-of-hours service is clearly displayed on the practice website, on the practice door and over the telephone when the surgery is closed.

• The practice is located within the area covered by NHS Lincolnshire West Clinical Commissioning Group (LWCCG). The CCG is responsible for commissioning services from the practice. A CCG is an organisation that brings together local GP’s and experience health professionals to take on commissioning responsibilities for local health services.

• The practice has a sister practice nearby which shares the same staff. This practice has a separate patient list however there are plans that they may merge in the future which will enable patients with more choice and flexibility in relation to appointments.

Updated 2 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Springcliffe Surgery, 42 St Catherines, Lincoln, LN5 8Z on the 14 and 15 April 2016. We carried out this inspection to check that the practice was meeting the regulations and to consider whether sufficient improvements had been made.

Our previous inspection in June 2015 found breaches of regulations relating to the safe delivery of services and concerns and regulatory breaches relating to the management and leadership of the practice, specifically in the well led domain. The concerns which led to these ratings applied to all population groups which meant that all six population groups were rated as requires improvement. The practice was rated as good in the effective, caring and responsive domains. The overall rating of the practice in June 2015 was requires improvement. Following the inspection, we received an action plan which set out what actions were to be taken to achieve compliance.

At the inspection in April 2016, we found the practice had made significant improvements since our last inspection in June 2015 and that they were meeting the regulations which had previously been breached.

We carried out an announced comprehensive inspection at Springcliffe Surgery on 14 and 15 April 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• All the partners and staff worked hard to undertake a complete review of the service since the previous inspection and made sustainable improvements.

• The practice had implemented a process for discussion of safeguarding issues.We saw that concerns were raised and were required patients were flagged with an alert, such as vulnerable adults, children and carers. Staff were aware of this system and what this meant.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents. Learning following investigation was shared at meetings and were necessary sent to all staff electronically. Annual reviews were carried out and presented to all staff. Low level, non clinical incidents were not always recorded although lessons were learned and documented in meetings.

• A locum procedure was in place to check that locums were appropriately qualified and fit to practice before they deliver a service to patients. We saw that a locum that was currently in place had all the required documentation.

• Risks to patients were assessed and well managed.

• Ensure emergency equipment and medicines were checked monthly in line with the practice policy.

• The practice had implemented a system to ensure that dispensed controlled drugs (CD) were appropriately recorded.

• The practice had a system to track prescription pads in line with national guidance.

• All staff had been trained in Mental Capacity Act (2005) and infection control.

• Staff had access to policies, procedures and guidance which are robust, reviewed and updated to enable them to carry out their role, for example, consent, management of medicines and repeat prescribing. The practice were moving over to having these stored on the practice intranet in addition to the paper copies.

• Patient surveys and feedback prompted the delivery of improvement.

• The practice had a number of policies and procedures to govern activity.

• The practice had commenced a triage system for all on the day appointments following feedback from patients that said they had to wait to see a GP. This was led by advanced nurse practitioners.
• Data showed patient outcomes were at or above average for the locality. Completed audits had been carried out, we saw some evidence that audits were driving improvement in performance to improve patient outcomes.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about services and how to complain was available and easy to understand.

The areas where the provider should make improvement are:

• Review the process of reporting significant events to include non-clinical incidents and near misses.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 June 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.

• Performance for diabetes related indicators showed the practice had achieved 99% of targets which was higher than both the CCG average (91%) and higher than the national average (89%).

• Longer appointments and home visits were available when needed.

• All patients with long-term condition 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 clinician worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 2 June 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.

• 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.

• The practice’s uptake for cervical screening programme was 67%, which was below the CCG average of 84% and the national average of 82% however the practice was aware of this and it had improved from five years previous.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 2 June 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.

• Falls assessment and advice was provided to patients at risk.

• All patients over the age of 75 had a named GP.

• The practice employed a practice nurse that was responsible for working with patients that were at risk of admission to hospital and also those that had recently been discharged.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice were linked to four care homes in the area were they had patients residing at and worked closely with the care home staff to provide reviews and home visits were necessary.

Updated 2 June 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 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.

• 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.

• Smoking cessation was offered in house, either face to face or over the telephone.

• Appointment triage and telephone consultations were available.

Updated 2 June 2016

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

• 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 including those that may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 2 June 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice had a register for patients who had a learning disability. They did not have an enhanced service but offered patients an annual medication review.

• 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.