Archived: Shortstown Surgery

Updated 18 May 2016

Shortstown Surgery has been a singlehanded practice since opening in 2007 and NHS England (NHSE) has arranged caretaker providers on two occasions since it opened. The staff from Wootton Vale Healthy Living Centre have been caretaking since June 2013. The current arrangement has been renewed three times since originally put in place and the future of the practice in terms of viability as a standalone facility has yet to be decided by NHSE. The current registered list size is 2382.

The caretaking providers have worked hard to remedy some previous issues but still face challenges mainly with the premises. The service is provided from a converted house with steep stairs, restricted opening hours (the premises cannot be used after 7pm or at weekends), lack of consulting space, along with poor staff facilities. The staff have made the best of the situation and have been innovative and adapted where they can to minimise the effects on patients and staff and provide the best service possible.

The practice has a large population from birth to four years of age and those aged 25 to 35 and a lower population aged between 55 and 85.

The reception is open between 8.15am and 6.30pm. Morning appointments are available Monday to Friday between 8.30am and 12.00pm. Afternoon appointments are available Mondays, Tuesdays and Thursdays between 2pm and 6.00pm. Afternoon and evening appointments are available Wednesdays and Fridays between 2pm and 7pm.

Appointments can also be booked on line. There is only one ground floor consulting room that the doctors and nurses use for patients with limited mobility and there is one nurse consulting room on the first floor. Issues in relation to consultation space and accessibility limit the number of appointments that can be booked; the practice has however set up remote access between the sites meaning there is constant access across the two sites. This enables reserving of limited room availability for face to face appointments.

The management have tried a number of different appointment patterns and staff mix to accommodate patients. The practice has now adopted a staff rotation process with Wootton which allows both clinical and administrative staff to feel part of a team to share experiences and for learning and support. This also increases patient choice and patients benefit from the speciality skills mix these doctors have, as well as continuity and gender of doctor.

The staff team work across both sites and include 2 GP’s; one male and one female, a practice manager, a female clinical manager, two practice nurses and three administration staff, one who is currently undergoing health care assistant (HCA) training and is also a phlebotomist.

Updated 18 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shortstown Surgery on 26 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, 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 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 and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was better than the CCG and national average. The practice achieved 94% of available points compared to the CCG average of 89% and the national average of 89%.
• There was a system in place to recall patients in this group.
• Lifestyle advice was given to patients where necessary to help their long term conditions.
• 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.

Updated 18 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 identified at potential risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively low for all standard childhood immunisations. The practice worked with the local children’s centre to improve parents understanding and fears concerning immunisation.
• 84% of patients diagnosed with asthma and on the Asthma register, who had an asthma review in the last 12 months which was above the CCG average of 77% and the national average of 76%
• 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 the cervical screening programme was 84%, which was similar to the CCG average of 83% and the national average of 82%
• 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 18 May 2016

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

The practice had a very low population range aged between 55 and 85 years.

• 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.
• The practice held multi-disciplinary meetings monthly to discuss palliative care and unplanned admissions to establish what level of monitoring and support was required.
• A register was held to identify and support patients at risk of an unplanned admission.

Updated 18 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 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 on line services as well as a full range of health promotion and screening that reflects the needs for this age group.
• A telephone call back is offered by the nurse practitioner based on the Wootton site, who had remote access the practice clinical systems, when a face to face consultation is not essential.

Updated 18 May 2016

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

• 100% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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 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 18 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 homeless people, and those with a learning disability.
• All patients with learning disabilities were offered an annual health check. Carers were contacted to attend and help to organise appointments for blood tests.
• Easy to read information was available to patients who confirmed they would prefer this way of communication.
• The practice offered longer appointments and additional support for patients in care homes and those 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.