Archived: Polkyth Surgery

Updated 10 March 2016

Polkyth Surgery is registered under the ownership of The Park Medical Centre. The Park Medical Centre along with the other four GP practices in St Austell have formed a consortium called The St Austell Healthcare Group Limited (SAHG). The SAHG are currently in the process of registering the consortium with us. The consortium has an agreement to assist with the management and care delivery of Polkyth Surgery.

On the 30 June 2015 the Polkyth Surgery closed and the 8,300 patients were invited to re-register with one of the other practices within the consortium.

The Polkyth location re opened on 3 August 2015 following refurbishment and rebranding and is now known as the Carlyon Road Health Hub. There are no patients registered at this new health hub, which provides an urgent same day appointment service for all the 32,000 patients registered at the other four practices within the consortium. Patients can visit or telephone the Health Hub.

The SAHG employs 100 staff, this includes 12 GP partners. A core of staff are permanently based at the Health Hub, whilst others rotate to particular practices within the group.

The Carlyon Road Health Hub is open Monday to Friday between 8am and 8pm with same day appointments available with a GP or nurse.  Appointments with an advanced nurse practitioner are available between 10am and 6pm. When the practice is closed, patients are directed to the out of hour’s service operated by another provider.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We undertook a comprehensive inspection of Polkyth Surgery on 22 January 2015. Polkyth is situated in the town of St Austell and has a patient group of 8300. The practice employs one full time salaried GP with the remaining sessions offering appointments being covered by locum GPs. The practice was rated as inadequate in respect of not being safe, effective or well led; requires improvement for providing effective services and good for being caring. Overall the rating is inadequate.

The practice is currently going through significant change following change of ownership in September 2014. There is only one full time salaried GP with locum GPs working other sessions. The overall responsibility for the practice is held by The Park Surgery, St Austell. The two other GP practices in the town, along with The Park Surgery, have formed a consortium known as the St Austell Healthcare Group Ltd, they have in place an agreement to help manage and lead Polkyth Surgery and support the improvements required.

Our key findings were as follows:

• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. We saw staff treated patients with kindness and respect, and maintained confidentiality.
• Some patients reported that they did not always see the same GP so did not experience continuity of care. Other patients reported difficulty in obtaining an appointment.
• Patients were at risk of harm because systems and processes were not in place, risks to safety had not been minimised. The practice had a new designated system in place for reporting, recording and monitoring significant events but these new systems had not yet been embedded into the practice. Medications were not managed safely and test results were not managed in a timely way.
• The practice did not have a clear vision and strategy. They had experienced severe disruption over the past six months. The GPs from the St Austell Healthcare Group were working with the NHS England local area team to ensure the practice continued to deliver a service. Staff we spoke with were not clear about their responsibilities in relation to the vision or strategy. There was no clear leadership structure in place.

The provider must:

• identify and monitor the training needs of staff to ensure they have an appropriate training updates and awareness of practice policy in key areas of health provision including; the Mental Capacity Act 2005, equality and diversity and safeguarding vulnerable adults and children, and basic life support.

• effectively monitor the quality of the service and identify, assess and manage risks to patients and others including; carry out clinical audits cycles; implement a quality assurance system (incorporating patient feedback); implement a system for disseminating alerts and new guidance; ensure staff are clear about lines of accountability; and consistently identify, record and investigate incidents and disseminate learning from significant events to staff.

• Implement a system to formally review patient’s medicines before prescriptions are given to patients. Prescription pads must be kept secure and GPs must sign all prescriptions before they are given to patients.

• Nursing staff must receive up to date training in vaccinating adults and children.

In addition the provider should:

• The Chaperone policy should be made more visible in the practice waiting room and each of the consulting rooms.

On the basis of the ratings given to this practice at this inspection, I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 May 2015

The practice is rated as inadequate for the care of people with long term conditions. Patients with long term conditions did not have a named GP. The practice nurses held clinics for patients diagnosed with conditions such as diabetes, respiratory and cardiovascular disease. The practice did not have systems in place to recall patients to the practice for monitoring and support. The nurses undertook this task when they had the time. Patient records and test results were not always being processed and reviewed in a timely way. Therefore this increased the risk of patients with long term conditions receiving delayed changes to their treatment and care.

Updated 8 May 2015

The practice is rated as requires improvement for providing services for families, children and young people. Cervical screening and family planning clinics were available one afternoon per week. Childhood immunisations were carried out at the practice, although some staff required update and training in vaccine administration. The waiting area and treatment rooms were able to accommodate patients with prams and there was a separate room for breast feeding, with baby changing facilities available. Advice on childhood illness and immunisations was available on the practice website.

Updated 8 May 2015

The practice is rated as inadequate for the care of older people. The practice employs one full time salaried GP with the remaining sessions offering appointments being covered by locum GPs. Patients over 75 years of age did not have a named GP. Patients reported that they were unable to see the same GP and this had impacted on their continuity of care. Home visits, from the practice matron, were arranged for housebound patients. Pneumococcal vaccination and shingles vaccinations clinics were provided at the practice for older patients.

Updated 8 May 2015

The practice is rated as inadequate for the care of working age people (Including those recently retired and students.) The practice employs one full time salaried GP with the remaining sessions offering appointments being covered by locum GPs. The practice does not offer extended opening hours for working people to book or access appointments. Changes to surgery times had been made but not communicated to patients, the patient participation group were also not aware that the Saturday surgery had been stopped. Patients were able to speak to a GP or nurse on the telephone. Prescriptions could be ordered via e mail. Pre bookable appointments were available. Health promotion advice was available on the website.

Updated 8 May 2015

The practice is rated as inadequate for the care of people experiencing poor mental health (including people with dementia). Some patients reported that they were unable to see the same GP and this had impacted on their continuity of care. The practice was unable to identify patients experiencing poor mental health or those with dementia. There was  information for this population group on the practice website.

Updated 8 May 2015

The practice is rated as requires improvement for the care of people whose circumstances may make them vulnerable. The practice did not hold a register of patients living vulnerable circumstances. It was unable to identify the percentage of patients who had received an annual health check. Most staff knew how to recognise signs of abuse in vulnerable adults and children and knew their responsibilities regarding information sharing of safeguarding concerns, however not all staff were aware of who to report their concerns to. The practice did not keep a register of carers.