South Green Surgery

Updated 12 January 2018

This practice is based in Grange Road, Billericay, Essex.

The current list size is around 3190 patients and the practice is open to new patients. There is one female lead GP and one regular male locum GP. The practice currently offers 121 face-to-face appointments per week as well as telephone consultations and home visits. There is a part-time female practice nurse working Mondays, Wednesdays and Fridays. The practice holds a general medical service contract (GMS). The practice is open on Monday to Friday 8am to 6.30pm.

Appointments are from 9am to 12.30pm Monday, Wednesday to Friday and 4.20pm to 5.30pm every afternoon. On Tuesdays appointments are 9am to 12.30pm and 4pm to 5.30pm. GPs will see emergency patients and complete home visits outside of these consultation sessions. Patients are able to book through the practice to see either a doctor or a nurse at the weekend, or weekday evenings, at a ‘hubs’. Out of hour’s cover is provided by East of England and patients calling the usual practice number will be transferred automatically to this provider.

The practice area demographic comprises of mainly white British, with other nationalities including those of mixed ethnicity and Asian. There are slightly higher than average numbers of patients aged 65-75. There are also higher than average number of patients in paid work or full-time education.

Updated 12 January 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at South Green Surgery on 14 June 2017. The overall rating for the practice was good, with requires improvement for well-led. The full comprehensive report on the June 2017 inspection can be found by selecting the ‘all reports’ link for South Green Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 28 December 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 14 June 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• The organisation of formal governance arrangements including the systems for assessing and monitoring risks was greatly improved.
• Although the practice had identified more patients who were carers, this could be improved further. Only 0.7% of the patient population had been identified as being a carer.
• The practice had implemented a system to monitor the use of blank prescription forms and pads.
• The practice had improved the security of the storage of external clinical waste.
• The practice had put in place an action plan following their patient survey and posted this on their website.

However, there was one area of practice where the provider still needs to make improvements.

The provider should:

• Continue to improve the identification of carers on their register.

At our previous inspection on 14 June 2017, we rated the practice as requires improvement for providing well led services as some of the governance systems required strengthening and reorganising. At this inspection we found that this was much improved therefore they are now rated as good for well-led.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 July 2017

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

• Nursing staff had lead roles in long-term disease management.
• Nationally reported data for 2015 to 2016 showed that outcomes for patients for long-term conditions were lower than compared to other practices locally and nationally for some indicators. For example, numbers of patients with diabetes receiving appropriate reviews were lower than the local and national average for some indicators and similar for others. The practice was aware of this and had worked to improve outcomes for this group. Unpublished data for 2016 to 2017 demonstrated improvements had been achieved.
• There was a system to recall patients for a structured annual review to check their health and medicines needs were being met. Patients were recalled sooner if required.
• 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.
• There was a system to involve patients throughout the individual care pathway process.

Updated 14 July 2017

The practice is rated as good for the care of families, children and young people.

• We found there were systems to identify and follow up children living in disadvantaged circumstances and those who were at risk.
• Clinical staff had an understanding of Gillick competence and Fraser guidelines.
• Immunisation rates were high for all standard childhood immunisations.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors to support this population group. For example, in the provision of antenatal, post-natal and child health surveillance.

Updated 14 July 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice recalled patients annually, or sooner depending upon the nature of their needs and diagnosis, for an assessment, review, including a medicine review.
• The practice ran influenza vaccination clinics within two local residential care homes.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 14 July 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible and flexible, for example, Saturday nurse appointments.
• The practice offered as a full range of health promotion and screening that reflects the needs for this age group. These included, well woman and well man checks.
• The practice offered meningococcal (MENC) vaccination for students.
• Nationally reported data showed that outcomes for patients for uptake of cervical smears were in line with other practices locally and nationally.
• The practice offered the electronic prescription service. This service allows patients to choose or ‘nominate’ a pharmacy to get their medicines from, the GP then sends the prescription electronically to the nominated place.
• Extended hours were available via a ‘hub’ service in the evenings and at weekends.

Updated 14 July 2017

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

• The percentage of patients diagnosed with dementia who had their care reviewed in a face-to-face meeting in the last 12 months was comparable to the national average.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses, with a care plan in their notes, was higher than the national average.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice offered a self- referral counselling service.

Updated 14 July 2017

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, travellers and those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and also how to contact relevant agencies in normal working hours and out of hours.
• The practice offered support in reading items to those patients who required it.
• The practice hosted a weekly session by a local housing association, where people could come in to discuss housing needs, benefits and debt.