Archived: Cradley Surgery

Updated 5 February 2015

Cradley Surgery is located in Cradley, near Malvern in Worcestershire and provides primary medical services to patients. The practice area is centered on Cradley village, and includes outlying villages and certain parts of Malvern. Cradley Surgery has a General Medical Services contract and is also a dispensing practice.

Cradley Surgery is an approved GP training practice. Fully qualified doctors (registrars) who want to enter into general practice spend 12 months working at the practice to gain the experience they need to become a GP.

The practice has one male and three female GPs, a male registrar, a practice manager, an assistant practice manager, two practice nurses, one healthcare assistant, dispensing, administrative and reception staff. There were 3492 patients registered with the practice at the time of the inspection. The practice is open from 8.30am to 11.30am and 4pm to 5.30pm Monday to Friday. Urgent appointments are available from 10.30am to 1pm daily.  Home visits are available for patients who are too ill to attend the surgery. The practice has four early morning appointments available on Tuesdays and Wednesdays for those patients who find it difficult attending during normal surgery hours.

The practice treats patients of all ages and provides a range of medical services. Cradley Surgery has a higher percentage of its practice population in the 65 and over age group than the England average. The practice provides a number of clinics such as asthma, diabetes and healthy heart clinic. It offers child immunisations, minor surgery, and maternity and child health surveillance services. Practice nurses can be seen by appointment for blood tests, ear syringing, dressings, injections, travel and routine immunisations, blood pressure, diabetic and asthma checks, cervical smears and general health advice. The practice does not provide an out of hours service but has alternative arrangements in place for patients to be seen when the practice is closed.

The practice works closely with another small local practice.  This provides both practices with clinical support. They share staff and resources for the benefit of their patients. For example, the practice manager works part time at this practice and part time at the other practice. The practice manager is supported by a full time assistant practice manager at Cradley Surgery. Both managers have been in post since April 2014. Alongside other significant staff changes during that time they have worked to develop and improve operating systems and procedures within the practice. 

Updated 5 February 2015

Letter from the Chief Inspector of General Practice

We inspected this service on 2 October 2014 as part of our new comprehensive inspection programme.  

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. We found the practice provided good care to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health. 

Our key findings were as follows:

• Patients were kept safe because there were arrangements in place for staff to report and learn from incidents that occurred. The practice had a system for reporting, recording and monitoring significant events over time.
• There were systems in place to keep patients safe from the risk and spread of infection.
• Evidence we reviewed demonstrated that patients were satisfied with how they were treated and that this was with compassion, dignity and respect. It also demonstrated that the GPs were good at listening to patients and gave them enough time.
• The practice had an open culture that was effective and encouraged staff to share their views through staff meetings and significant event meetings. 

There were areas of practice where the provider needs to make improvements.

The provider should:

• Review all policies and procedures so that the provider can be assured that medicines are managed effectively, according to best practice and within legal requirements

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 February 2015

The practice is rated as good for the care of people with long-term conditions. Emergency processes were in place and referrals were made for patients in this group who had a sudden deterioration in their health. Longer appointments and home visits were available when patients needed them. All these patients had a named GP and structured annual reviews to check 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 5 February 2015

The practice is rated as good for the care of families, children and young people. Systems were in place for identifying and following-up children who were at risk. For example, children and young people who failed to attend appointments or clinics. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us and we saw evidence that children and young people were treated in an age appropriate way and recognised as individuals.

Appointments were available outside of school hours and the premises were suitable for children and babies. We were provided with good examples of joint working with midwives, health visitors and school nurses. Emergency processes were in place and referrals were made for children and pregnant women who had a sudden deterioration in health.

Updated 5 February 2015

The practice is rated as good for the care of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. They provided a range of enhanced services, for example in dementia and end of life care.

The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs and home visits.

Updated 5 February 2015

The practice is rated as good for the care of the population group of the 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 a full range of health promotion and screening which reflected the needs of this age group.

Updated 5 February 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had in place advanced care planning for patients with dementia.

The practice had sign-posted patients experiencing poor mental health to various support groups and other organisations. This included organisations such as the ‘2gether Trust’ in Herefordshire and other community based services that provided support for patients of all ages with mental health needs. A community psychiatric nurse visited the practice once a week to see patients. This service was commissioned by the clinical commissioning group.

Updated 5 February 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 learning disabilities. The practice had carried out annual health checks for patients with learning disabilities.  The practice offered longer appointments for patients with learning disabilities.

The practice regularly worked as members of multi-disciplinary teams in the case management of vulnerable patients. The practice had sign-posted vulnerable patients to various support groups and other 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 and out of hours.