Archived: County Surgery

Updated 25 February 2016

County Surgery provides primary care medical services to approximately 3,900 patients who live in an area of Northampton. The practice provide services under a General Medical Services (GMS) contract agreed nationally. The practice population is made up of a variation of ethnic groups, including Bengali, Bangladeshi and Iraqi and data suggests the area is one of moderate levels of deprivation.

The practice has two GP partners and employs a practice nurse, a health care assistant, a part time practice manager who is supported by a senior administrator and a team of administrative and reception staff. The practice told us the current practice manager is leaving and the senior administrator is being trained and developing into this role supported by the partners and current manager. The practice operates from a two storey premises with nursing, administrative and clerical staff on the first floor and all GP patient consultations take place on the ground floor. The practice does not have parking facilities on site but there is roadside parking available in nearby streets.

The practice is open on Monday, Wednesday, Thursday and Friday from 8am until 6.30pm and Tuesdays from 7.30am until 6.30pm. In addition, the practice open from 6.30pm until 8.30pm one Wednesday per month. When the practice is closed services are provided via the 111 service.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at County Surgery on 12 January 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 and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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 and were positive regarding open access surgery on Monday and Fridays.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

There were two areas where the provider should make improvements:

• The practice should review the chaperone policy to ensure it reflects GMC guidelines and the practice’s own current chaperoning arrangements.

• The practice should formalise infection control arrangements to ensure that audits are carried out regularly.

• The practice should consider ways to improve the patient experience in some areas in response to the national patient survey results.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 25 February 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice nursing staff had lead roles in chronic disease management and the practice employed locum nurses with specific skills to review some chronic conditions. Patients at risk of hospital admission were identified as a priority using risk stratification tools.

• 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 example, 97% of patients diagnosed with asthma, had received had an asthma review in the last 12 months.

• 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 25 February 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. Immunisation rates were 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.

• The practice offered cervical screening and had performed this on 80% of the population who met the criteria for this test in the last five years.

• 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 and health visitors.

Updated 25 February 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.

Updated 25 February 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 offered appointments early in the morning and later in the evening one day a week to provide access to appointments for those patients who work during the day.

• 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.

Updated 25 February 2016

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

• All patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is above the national average.

• Eighty-two percent of patients on the mental health register had a comprehensive care plan in place and documented in their records.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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.

• 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 25 February 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 and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.