Salisbury Medical Practice

Updated 12 January 2023

Salisbury Medical Practice is located in Salisbury, Wiltshire at:

Fisherton House

Fountain Way

Wilton Road

Salisbury

Wiltshire

SP2 7FD

The practice has branch surgeries located at:

Bemerton Heath Surgery

Pembroke Road

Salisbury

Wiltshire

SP2 9DJ

The following branch surgery was temporarily closed at the time of inspection:

Bishopdown Surgery

28 St Clements Way

Bishopdown

Salisbury

Wiltshire

SP1 3FF

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning, treatment of disease, disorder or injury and surgical procedures. These are delivered from all sites.

The practice offers services from both a main practice site and branch surgeries. At the time of inspection, patients could access services at either the main practice, Fisherton House, or at the branch, Bemerton Heath Surgery. We did not visit the branch surgeries during this inspection.

The practice is situated within the Wiltshire Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 24,000. This is part of a contract held with NHS England. The practice is also commissioned to provide additional minor surgeries and vasectomies to residents within Wiltshire.

The practice is part of a wider network of GP practices, Sarum Cathedral Primary Care Network (PCN), comprised of Salisbury Medical Practice and Harcourt Medical Centre. This is led by a Clinical Director and a board of seven members. Patients registered at these practices are also part of the PCN and are able to benefit from services offered including; a Care Home and Frailty Service; a dedicated Pharmacy team and a Social Prescriber team.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the third highest decile (seven of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 96.2% White; 2.1% Asian; 1.1% Mixed; 0.4% Black and 0.2% Other.

There is a team of 12 GP Partners and five salaried GPs who provide cover at the main practice and branch locations. The practice has a team of five practice nurses and two specialist nurses who provide clinics for long-term conditions, female health and immunisations. The practice has a pharmacy team comprised of Additional Roles Reimbursement Scheme (ARRS) pharmacists and a pharmacy technician. The GPs are supported by a Practice Manager to provide managerial oversight, a HR manager and a total team of 48 non-clinical staff, including reception/administration staff.

Salisbury Medical practice is a teaching and training practice providing placement for GP Registrars, medical students and nurses. At the time of inspection, there was three GP trainers and two GP retainers. They had a trainee practice nurse, a trainee nurse associate and an apprentice nursing team assistant.

The practice is open between 8am to 6:30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally by Wiltshire Health in Care, where late evening and weekend appointments are available. Out of hours services are provided by NHS 111.

Updated 12 January 2023

We carried out an announced comprehensive inspection at Salisbury Medical Practice on 18 November 2022. We have rated the practice as Good overall.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection in November 2018, the practice was rated Good overall and for all key questions, with Outstanding for providing responsive services.

At the last inspection we rated the practice as outstanding for providing responsive services because:

• The practice had a clear vision of using social prescribing and social care signposting to support patients, by improving their social network, encouraging social activity and making sources of help and advice more easily accessible.

At this inspection, we found that those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. While the provider had maintained this good practice where possible, the COVID-19 pandemic impacted the delivery on some of these services and not all had resumed at the time of inspection. The threshold to achieve an outstanding rating therefore had not been reached. The practice is therefore now rated Good for providing responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Salisbury Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up concerns reported to us by members of the public in relation to patient access. This included:

• Safe, Effective, Caring, Responsive, Well-led domains
• Risks identified in relation to patient access through complaints to CQC.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.
• Obtaining information and feedback by external stakeholders.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Improve the uptake of cervical cancer screening to eligible patients.
• Continue to respond to complaints in a timely way and maintain a full audit trail of correspondence relating to all complaints, including acknowledgement letters.
• Take action to uphold oversight of required Controlled Substances Hazardous to Health (COSSH) data sheets in relation to all cleaning products stored at the practice.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services