Eastfield House Surgery

Updated 3 May 2018

Eastfield House Surgery is located near the town centre of Newbury. Approximately 13,300 patients are registered with the practice. The number of patients registered has increased in the last three years due to a number of new housing developments in the Newbury area. The practice premises were purpose built approximately 20 years ago. The building was recently expanded to provide new consultation rooms. Patients are registered from the town and local area. The practice population has patients in local care homes, schools and a homeless shelter. There is minimal deprivation according to national data. The proportion of patients with a long standing health condition is 38% compared to 54% nationally.

It is open from 8am to 6.30pm. Extended hours appointments are available two evenings a week and frequently on Saturday mornings.

Care and treatment is delivered by nine GPs, with two male and seven female GPs, four practice nurses, a health care assistant and two practice matrons. There is a management team, administration and reception staff.

The practice is a member of Newbury and District Clinical Commissioning Group. The practice has a General Medical Services (GMS) contract. GMS contracts are directly negotiated between the General Medical Council and the practice.

All services are provided from Eastfield House Surgery, 6 St Johns Road, Newbury, RG14 7LW. Further information about the practice is available on their website at: www.eastfieldhousesurgery.co.uk

The practice has opted out of providing out-of-hours services to its own patients. There are arrangements in place for patients to access care from an out-of-hours provider, Westcall, via NHS 111.

Updated 3 May 2018

This practice is rated as Good overall. (Previous inspection December 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Eastfield House Surgery on 20 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. For example, clinical staff received enhanced training to deal with a range of life threatening conditions that patients might encounter whilst at the practice.
• The practice ran a personalised list system to deliver continuity of care for patients.

• There was a focus on prevention of health problems arising. This included scanning for liver problems, pre diabetes assessments and dementia screening.
• There were effective systems in place to monitor usage of prescribed medicines. Data showed that 99% of patients taking four or more repeat medicines had received a review of their medicines in the last year.The practice employed practice matrons to support patients with complex needs and those whose condition made it difficult to attend the practice for appointments. For example, patients who had mental health problems and did not wish to attend the practice could be seen at their own home.

The areas where the provider should make improvements are:

• Monitor the systems changes made on the day of inspection to evaluate their effectiveness and sustainability.
• Review the implementation of annual health checks for patients diagnosed with a learning disability.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 January 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. 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 28 January 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 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 28 January 2016

The practice is rated as good for the care of older people. We found staff had appropriate background checks to ensure they were safe to work with vulnerable adults. Significant events and complaints were appropriately investigated, reviewed and action taken. There was a clinical audit programme used to drive improvements to clinical outcomes for older patients. 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.

Updated 28 January 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. Pre-bookable appointments were freely available. There was some difficulty identified from patient feedback in booking on the day appointments.

Updated 28 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All staff had appropriate background checks to ensure they were safe to work with vulnerable adults and children. National data showed 80% of people 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 with dementia. There was evidence of  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.

Updated 28 January 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. All staff had appropriate background checks to ensure they were safe to work with vulnerable adults and children. The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and but the recording of these patients having a single formal health check was low. The practice accounted for the remaining patients who had not had a health check-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 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.