The Surgery Rugby Road

Updated 19 November 2015

The Surgery Rugby Road opened in June 1991. It is situated in the rapidly growing village of Bulkington surrounded by other villages like Barnacle and Shilton and part of Wolvey. The surgery also caters for Bedworth, Whitestone and a small number of patients in Withybrook. The practice has 3,400 patients.

There is a parking space reserved for disabled persons at the practice. The main entrance, reception, all downstairs consulting rooms and disabled toilets are designed to allow easy wheelchair access.

There is a branch surgery based at the Health Centre in Bedworth and its practice area extends to Exhall, Ash Green and part of Longford in Coventry. We had no specific information about the branch surgery to lead us to visit there and the inspection therefore focussed on the main site. The Surgery has managed this since September 1993, with the present building being completed in 1996.

The practice has one lead GP and two regular long term locum GPs, one female and one male, providing patients with a choice. The practice has 2 part time practice nurses. The clinical team are supported by a practice manager and a team of five reception and administrative staff.

The practice provides a range of minor surgical procedures to patients.

The practice has a patient participation group (PPG), a group of patients registered with a practice who work with the practice team to improve services and the quality of care.

The practice has a General Medical Services (GMS) contract with NHS England.

Data we reviewed showed that the practice was achieving results that were higher than or in line with national or Clinical Commissioning Group (CCG) averages in respect of most conditions and interventions.

The practice does not provide out of hours service for their own patients but provided information about the telephone numbers to use for out of hours GP arrangements (NHS 111).

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Surgery Rugby Road on 19 August 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. Lessons learned were regularly discussed at team meetings.

• Risks to patients were assessed and well managed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.

• 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.

• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. Patient reviews were routinely carried out and some of the patients lived in care homes in the local area.

• 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 management. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure that an accurate record is kept of meetings relating to significant events and complaints to facilitate the sharing of learning and analysis of patterns and trends

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

The practice is rated as good for the care of patients with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of unplanned 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 that their health and medication needs were being met. Annual osteoporosis audits were carried out and medication was changed in accordance with guidelines. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. Patients with uncontrolled diabetes were referred to the long term GP with a specialist interest in diabetes.

Updated 19 November 2015

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. Appointments were available outside of school hours and the premises were suitable for children and babies. Baby and postnatal checks were usually done together within normal surgery time to provide extra flexibility for families. We saw good examples of joint working with midwives, health visitors and school nurses. Well woman clinics were run by the nurses. The lead GP and one of the long term locums were able to fit and remove coils for patients.

Updated 19 November 2015

The practice is rated as good for the care of older patients. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services. High risk patients were discussed at the unplanned admission avoidance meeting every two months. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs and personalised care plans were given to patients. Patients over the age of 75 were offered health checks and dementia screening.

Updated 19 November 2015

The practice is rated as good for the care of working-age patients (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. This meant that appointments could be booked over the telephone 24 hours a day without the need to speak with a receptionist. The practice offered extended hour services on a Monday from 6.30pm to 8.15pm excluding the third Monday in the month. The practice also offered extended hours services the third Saturday of every month from 9am to 10.30am.

Updated 19 November 2015

The practice is rated as good for the care of patients experiencing poor mental health. A total of 89% of patients who experienced poor mental health had received a health check in the last 12 months. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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 worked closely with Improving Access to Psychological Therapies (IAPT) workers for patients who experienced poor mental health. The practice also worked closely with the community psychiatry nurse (CPN) and secondary care. The practice liaised with the crisis resolution team for patients who needed immediate help. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 19 November 2015

The practice is rated as good for the care of patients 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. It had carried out annual health checks and offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people such as the Recovery Partnership. This is an integrated and recovery-focused treatment service for residents across Coventry and Warwickshire with a drug or alcohol problem. One of the long term locums had a special interest in substance and alcohol misuse. It had told 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.