Horndean Surgery

Updated 10 September 2015

Horndean Surgery is situated in Horndean, a rural village north of Portsmouth, Hampshire.

The practice has an NHS general medical services contract to provide health services to approximately 4,700 patients.

The practice is open from 8.00am to 6.30pm from Monday to Friday. Appointments are available between 8.30am and 6.00pm from Monday to Friday. Extended hours surgeries are also offered on Monday evenings between 6.30pm and 8.00pm and Saturday mornings between 9.00am and 11.00am

The practice has opted out of providing out-of-hours services to their own patients and refers them to Care UK via the NHS 111 service.

The practice population is higher than the national average for patients aged over 45 years old and lower than the national average for patients under this age. We were told that the area is within easy commuting distance of major towns and London, which encourages a higher number of patients of working age. The rate of unemployment in the area is lower than both the average for Hampshire as well as nationally.

The practice has six GPs who together work an equivalent of 3.5 full time staff. In total there are three male and three female GPs. The practice has a nurse prescriber, two practice nurses and a health care assistant. The GPs and the nursing staff are supported by a team of five administration staff who carry out administration, reception, scanning and secretarial duties. The practice also has a lead receptionist and a practice manager.

The practice is a training practice for doctors training to be GPs.

We carried out our inspection at the practice’s only location which is situated at:

Blendworth Lane

Horndean

Waterlooville

PO8 0AA

Updated 10 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Horndean Surgery on 21 July 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.
• 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 and any further training needs had been identified and planned.
• 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.
• 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.

• Maintain records of previous infection control audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 September 2015

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. 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. 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.

Updated 10 September 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. 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. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 10 September 2015

The practice is rated as good for the care of older people. 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, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 10 September 2015

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.

Updated 10 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people living with dementia). At the practice 97% of patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those living with dementia. It carried out advance care planning for patients with a diagnosis of dementia.

The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) whern 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 10 September 2015

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. It had carried out annual health checks for people with a learning disability and 79% of these patients had received a follow-up. It offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients 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.