Highlands Surgery

Updated 11 February 2016

Highlands Surgery is located on the London Road in a predominantly residential area in Leigh on Sea, Essex. The practice provides services for 11500 patients. The practice operates from purpose built premises.

The practice holds a General Medical Services (GMS) contract and provides GP services commissioned by NHS England and Southend Clinical Commissioning Group. A GMS contract is one between GPs and NHS England and the practice where elements of the contract such as opening times are standardised.

The practice population is similar to the national average for younger people and children under four years, and for those of working age and those recently retired, and significantly higher for older people aged over 65 years. Economic deprivation levels affecting children, older people are lower than the practice average across England. Life expectancy for men and women are similar to the national averages. The practice patient list compares similarly to the national average for long standing health conditions and the national averages for working aged people in employment or full time education and those of working age that are unemployed.

The practice is managed by three GP partners who hold financial and managerial responsibility. The practice employs two salaried GPs. In total four male and one female GP work at the practice. In addition the practice employs five practice nurses, a practice manager, a deputy practice manager and a team of reception and administrative staff.

The practice is open between 8am and 6.30pm on weekdays. GP and nurse appointments are available between 8.15am to 6pm daily. Pre-booked nurse appointments are available between 9am and 12pm on Saturdays.

The practice has opted out of providing GP out of hour’s services. Unscheduled out-of-hours care is provided by the NHS 111 service and patients who contact the surgery outside of opening hours are provided with information on how to contact the service. Patients at the practice have access to a service where they were able to book an appointment with a GP via an app on their mobile phone or tablet. Patients had the choice of a video or telephone consultation without having to visit the surgery. This is available between 8am and 8pm on Mondays to Saturdays and between 4pm to 8pm on Sundays.

Updated 11 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Highlands Surgery on 28 October 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice ensured that when things went wrong that these were investigated and learning was shared with staff. Risks to patients were assessed and well managed. There were systems for assessing risks including risks associated with medicines, premises, equipment and infection control.
• There was a detailed business continuity plan to deal with untoward incidents that may affect the day to day running of the practice.
• Staff were recruited robustly with all of the appropriate checks carried out to determine each person’s suitability and fitness to work at the practice.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Clinical audits and reviews were carried out to make improvements to patient care and treatment.

• Staff were supported and received role specific training to meet the needs of patients and there was a system for staff appraisal.
• 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. Complaints were investigated and responded to appropriately and apologies given to patients when things went wrong or their experienced poor care or services.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 February 2016

The practice is rated as good for the care of people with long-term conditions. GPs and nursing staff had lead roles in chronic disease management and provided a range of clinics including asthma, diabetes and chronic obstructive pulmonary disease (COPD). The practice performance for the management of long term conditions was similar to or higher than other GP practices nationally.

• Patients at risk of unplanned 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.
• Patients at the practice had access to a service where they were able to book an appointment with a GP via an app on their mobile phone or tablet. Patients had the choice of a video or telephone consultation without having to visit the surgery.
• Online booking and telephone consultations were available.
• Health events were held and information was available to support patients to maintain good health.

Updated 11 February 2016

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

• The practice offered same day appointments for children. Appointments were available outside of school hours.
• Family planning services, post-natal and baby checks were available as were appointments to monitor the development of babies and the health of new mothers.
• 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. The practice held monthly in-house safeguarding meetings with relevant health professionals including health visitors to review children who were identified as being at risk.
• Immunisation rates were similar to other GP practices 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.

Updated 11 February 2016

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

• Home visits and appointments with GPs and nurses.
• Dedicated admissions avoidance nurse and regular multidisciplinary team meetings to help reduce unplanned hospital admissions for frail, elderly and patients who were receiving palliative care.
• Dementia screening and care plans for patients.
• High rates of seasonal flu / shingles vaccinations.
• Named GP for patients over 75 years.

Updated 11 February 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.

• Appointments with a practice nurse were available on Saturday mornings.
• Online appointment booking and electronic prescribing was available.
• Patients had access to a service where they were able to book an appointment with a GP via an app on their mobile phone or tablet. Patients had the choice of a video or telephone consultation without having to visit the surgery.
• The practice was proactive in offering online services including on-line appointment booking and electronic prescribing (where patients can arrange for their repeat prescriptions to be collected at a pharmacy of their choice).
• The practice offered a full range of health promotion and screening that reflected the needs for this age group including NHS health checks.

Updated 11 February 2016

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

• Staff at the practice were proactive in carrying out dementia screening and liaised regularly with the dementia community nurses to ensure that care was coordinated and effective to meet patient’s needs. The practice reviewed and monitored patients with dementia and carried out face-to-face reviews
• Patients with mental health conditions were reviewed and had an annual assessment of their physical health needs and medicines. Longer appointments and home visits were provided as required. The practice supported patients who lived at a local hostel and provided same day appointments when required.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. This included the mental health crisis line and Therapy for You services.
• It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 11 February 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Staff undertook safeguarding training and the practice had a dedicated safeguarding lead. 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.

• The practice held a register of patients living in vulnerable circumstances including patients with a terminal illness and those with a learning disability.
• Patients who were identified as vulnerable had a named nurse who had accountability for their care.
• The practice proactively promoted annual health checks for patients with learning disabilities and nurses had received specific training to support these patients. Information about annual health checks was available in an easy read pictorial format to assist patients understand these checks.
• Home visits were available for reviews as needed.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. This helped to ensure that patients whose circumstances made them vulnerable were supported holistically and that patients who were at a higher risk of unplanned hospital admissions were supported to and treated in their home.