Archived: Upton Rocks Surgery Also known as SSP Health Ltd

Updated 22 October 2015

Upton Rocks Surgery is located in the car park of Widnes Rugby Union car park, and services are delivered from portacabin building. The surgery has been operating from the portacabin for approximately 15 years. The practice serves approximately 3,000 patients. All services are delivered under a Personal Medical Services contract (PMS). The provider responsible for delivering services is SSP Health Ltd.

The practice is open between 8am and 6.30pm Monday to Friday, and open late on a Monday evening until 7.30pm.

Morning surgery times are between 9am and 11.30am Monday to Friday. Afternoon surgery times are between 4pm and 6.00pm on Monday, Tuesday and Wednesday of each week, with an extended hours surgery on Monday until 7.00pm. On Thursday and Friday of each week, afternoon surgeries are from 4pm to 5.30pm. We noted that although surgery times are given on Monday as being throughout the day, no GP is on site until the late surgery. An advanced nurse practitioner is available at the practice during this period. If patients call the practice out of hours, they are diverted by phone to the out of hours service, provided by an alternative provider, Urgent Care 24 (UC24).

The practice premises are made up of two GP consulting rooms, two nurses rooms and a separate consulting room available to the health visitor who assists with childhood and new born developmental checks. There is a practice managers office, one patient reception area with receptionists working area, and a meeting and administration room. Staff have access to a staff room for breaks away from their workstations. The practice has patient toilet facilities and baby changing area, both of which are accessible for people with limited mobility. Patients who require a more private room, for example, breast feeding mothers or patients wishing to discuss a matter away from the reception area can access the room used by the health visitor. The practice was awarded a ‘Baby Welcome’ accreditation from the Department for Health for making the practice accessible to and welcoming for nursing mothers and parents with young children.

The practice staff include two long term locum GPs, one male and one female. The practice also employs two nurses, one of which is an advanced nurse prescriber. The clinical team is supported by a health care assistant. The practice administrative support team was made up of four staff who were led by the practice manager.

The practice operates a branch surgery three times a week for two hours on a Monday, Wednesday and Friday afternoon, to provide support for patients who historically have used this service. We did not visit the branch surgery as part of our inspection, but all records relating to the branch surgery could be accessed from the site at Widnes Rugby Union car park.

The demographic of the practice varied from the national picture, with a larger than average working age population, and fewer patients from the older population group (over 75 years). This was true for male and female patients. The practice is located in an area that falls within one of the least deprived decile (measurement in tenths of population), where male life expectancy is 77 years of age and for women is 81 years of age.

Updated 22 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Upton Rocks Surgery, Widnes, Cheshire on 10 September 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and training planned to address these.
• Patients said they were treated with compassion, dignity and respect.
• Information about services and how to complain was available and easy to understand.
• 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.
• 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.

However there were areas of practice where the provider could make improvements.

The provider should

• Review arrangements for patient access to a GP on Monday’s to ensure this adequately meets patients needs, and make the current arrangement for GP access on Monday’s clearer to patients.
• Take steps to improve patient experience with GPs, as identified in the last NHS England GP Patient Survey.
• Increase the participation rates of patients in the Friends and Family test to provide a balanced picture of patient focussed services at the practice.
• Follow-up the required NICEIC certificate in respect of electrical safety of the premises.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 October 2015

The practice is rated as good for the care of people with long-term conditions. The practice nurse had a lead role 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. For those people with the most complex needs, their GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 22 October 2015

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. The practice nurse and GPs demonstrated 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, for ease of access of younger patients.

Updated 22 October 2015

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 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. It was responsive to the needs of older people, and offered home visits for those with enhanced needs.

Updated 22 October 2015

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 on-line services, for example booking appointments and ordering of repeat prescriptions on-line. The practice offered a full range of health promotion and screening that reflected the needs for this age group.

Updated 22 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. 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. Staff had received training on how to care for people with mental health needs and dementia.

Updated 22 October 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 a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. 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.