Wickhambrook Surgery

Updated 16 March 2017

The Wickhambrook Surgery is situated in Wickhambrook, Suffolk. The practice provides services for approximately 4450 patients. They hold a General Medical Services contract with NHS West Suffolk CCG.

The most recent data provided by Public Health England showed that the patient population has a higher than average number of patients aged between 45 and 85, and a lower than average number of patients aged between one to 44 compared to the England average. The practice is located within an area of low deprivation.

The practice has three partners, two male and one female, a salaried GP (female) and one trainee GP. The team includes two practice nurses, one healthcare assistant/phlebotomist. The clinical staff are supported by a team of dispensary, administration and reception staff who are led by a practice manager. At the time of inspection, the practice was open between 8.00am to 6.30pm Monday to Friday. GP appointments were available every day between the hours of 9.00am to 11.30am and 3.30pm to 6.00pm whilst nurse appointments were available every day between 9.00am to 11.30am and 3.00pm to 5.30pm. Extra appointments were available through Suffolk GP+ after practice opening hours until 9.00pm during the week and  also between the hours of 9.00am and 2.00pm at the weekends. Care UK provides out of hours GP services at all other times.

Updated 16 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wickhambrook Surgery on 6 June 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 although actions put in place in response to significant events were not always reviewed.
• Risks to patients were assessed and managed although improvement was required with regards to fire drills and equipment checks, infection control training, recruitment checks relating to locum GPs, and cleaning processes.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care was positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the most recent National GP Patient Survey showed that patients rated the practice higher than others for several aspects of care.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a GP and 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.

The areas where the provider must make improvement are:

• Review and implement processes relating to consumable expiry date checks.

The areas where the provider should make improvement are:

• Review actions put in place after significant events.

• Regularly review fire safety arrangements.

• Review the cleaning schedule to ensure all relevant areas of the practice are included.

• Ensure staff are up to date with infection control training.

• Monitor the recently introduced system to track prescription pads to ensure it remains effective.

• Ensure robust process for completing recruitment checks prior to employment of locum GPs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 September 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.

• The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2014/2015 showed that performance for diabetes related indicators was 97%, which was above the CCG average by 5% and the national average by 7%. The practice reported 8% exception reporting, which was 4% below CCG and 3% below the England average.

• Longer appointments and home visits were available when needed.

• 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 20 September 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, for example, children and young people who had a high number of A&E attendances. Immunisation rates were higher for some of the standard childhood immunisations but slightly lower for others. For example, data from 2014/2015 showed the percentage of children receiving the PCV vaccination for the age group of 12 months was 100% compared to the CCG average of 94.7%, however the percentage of children receiving the PCV booster vaccination for the age group of 24 months was 89.7% compared to the CCG average of 94.1%.

• The practice’s uptake for the cervical screening programme was 83%, which was in line with the CCG and England averages 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 other health care professionals. For example, the health visitor held baby clinics at the practice on a monthly basis.

Updated 20 September 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.

• The practice was flexible with appointments to allow patients to attend with carer’s availability.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure, were in line or above local and national averages.

• The practice offered a medicine delivery service which included a weekly delivery of dossette medication.

Updated 20 September 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 online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice provided telephone slots to give advice to those who could not attend the practice.

• As a result of patient feedback the surgery had increased the number of appointments available to book on-line.

• The practice ensured that the surgery and dispensary were open at all times during the day to enable patients to access services and make appointments at a time convenient to them.

Updated 20 September 2016

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

• 82% of patients diagnosed with dementia had had their care reviewed in a face-to-face meeting in the last 12 months, which was in line with the CCG average of 82% and the England average of 84%. The exception reporting rate was 4% which was lower than the CCG average of 9% and the England average of 8%.

• 95% of patients experiencing poor mental health had a comprehensive, agreed care plan documented in their record in the preceding 12 months, which was above the CCG and England average of 88%. The exception reporting rate was 5% compared to the CCG average of 15% and the England average of 13%.

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

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 20 September 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 those with a learning disability.

• 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 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.