• Doctor
  • GP practice

Archived: New Milton Health Centre

Overall: Good read more about inspection ratings

Spencer Road, New Milton, Hampshire, BH25 6EN (01425) 621188

Provided and run by:
New Milton Health Centre Practice

Latest inspection summary

On this page

Background to this inspection

Updated 15 March 2017

New Milton Health Centre is a purpose built medical facility. The practice shares the premises with a range of other health clinics including for example, talking therapies and specialist dental services. The health centre is close to public transport links and there are disabled parking facilities available. All consulting and treatment rooms are on the ground floor and the premises are accessible to patients that use wheelchairs or have mobility problems.

The practice has a registered patient population of approximately 9,900. Data shows that there is a significantly higher than average number of patients registered over the age of 65 and far fewer than average under the age of 50. For example there are more than double the national average of patients aged over 85 registered with the practice. The practice has patients registered with them that live in 23 care homes in the locality. Whilst nationally reported data shows limited income deprivation in the locality, the practice is aware that this is an issue in parts of the area it serves. The practice provides services to the registered population via a General Medical Services (GMS) contract. (A GMS contract is the most common type of contract and is negotiated nationally with NHS England)

There are seven GP partners (three male and four female) at the practice. They are equivalent to 4.75 whole time GPs. The practice is accredited to provide training to qualified doctors who are seeking to become GPs. At the time of inspection there were two trainee GPs at the practice. There are six members of the practice nursing team. Four are practice nurses of whom two are qualified to prescribe an approved range of medicines for patients with minor illnesses and long term conditions. The nurses are supported by two health care assistants (HCAs). The day to day management of the practice is led by the practice manager who is supported by a team of 25 administration and reception staff.

The practice is open between 8.30am and 6.30pm Monday to Friday. Appointments were from 8.30am to 12pm every morning and 2.30pm to 6.20pm daily. Extended hours appointments were offered from 7.30am on both Wednesday and Thursday and until 7pm on a Monday and Wednesday.

The practice has opted out of providing out of hours services to their patients. Out of hours services are provided by the local out of hours provider Partnering Health Limited (Hampshire Doctors on Call)). The out of hours service is accessed by calling NHS 111. The arrangements in place for services to be provided when the surgery is closed are displayed at the practice and in the practice information leaflet.

All services are provided from: New Milton Health Centre, Spencer Road, New Milton, Hampshire, BH25 6EN.

Overall inspection

Good

Updated 15 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Milton Health Centre on 5 January 2017. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patient feedback was consistently positive.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. The practice made use of electronic ways of accessing advice and treatment. Patients that worked commented on how useful they found this service.
  • 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.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • The practice used care registers to identify those patients in need of additional support and assistance. For example, 97% of the 59 patients diagnosed with a learning disability had received an annual health check in the last 12 months.

  • There was an innovative approach to delivery of care and the practice piloted new services. For example, it had led in the development of single patient record with other health providers in the locality.

  • There was a focus on the needs of each population group registered and recognition of the higher than average elderly population. For example, one GP specialised in care of the frail elderly.

  • The practice demonstrated a commitment to health promotion and prevention of poor health. Nationally reported data showed effective performance in delivering smoking cessation advice and in monitoring blood pressure to prevent further health problems developing.

  • The practice was proactive in identifying patients with caring responsibilities and delivering advice and support to this group.

We saw one area of outstanding practice:

  • Governance and performance was kept under regular review by use of a 36 point key performance indicator programme. Services were adjusted when the need for further improvement was identified, such as appointments could be added at times of peak demand. The KPI’s had enabled the practice to match resources to demand by closely monitoring practice performance.

The areas where the provider should make improvement are:

  • Ensure that blank prescription stationery tracking identifies which prescriber or clinical room prescriptions have been issued to.

  • Ensure all responses to complaints detail the route to escalate a complaint if the patient feels it necessary to do so.

  • Ensure a review of exception reporting for patients diagnosed with diabetes is undertaken.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 15 March 2017

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.

  • Performance for diabetes related indicators was 100% which was above both the clinical commissioning group (CCG) average of 93% and national average of 90%. For example, 97% of patients diagnosed with diabetes achieved target blood pressure compared to the CCG and national average of 91%.

  • All patients diagnosed with coronary heart disease, COPD (a type of lung disease) and Asthma had received a review of their medicines in the last twelve months.

  • Longer appointments and home visits were available when needed.

  • All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 15 March 2017

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.

  • The practice’s uptake for the cervical screening programme was 87%, which was comparable to the CCG average of 82% and the national average of 81%.

  • Appointments were available outside of school hours and the premises were suitable for children and babies.

  • We saw positive examples of joint working with midwives and health visitors.

  • The practice website held an identified section for younger patients called ‘teenzone’ that contained health advice and information specific to this patient group.

Older people

Good

Updated 15 March 2017

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

  • The practice offered proactive, personalised care to meet the needs of the older people in its population.

  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

  • One of the GPs had undertaken additional training that enabled them to specialise in care of the frail elderly.

  • The practice GPs supported patients that lived in 23 local care homes.

  • There was a high level of home visiting to meet the needs of patients who could not attend the practice. Data showed there was an average of 20 visits per day.

  • Care plans were agreed with the most frail and elderly 2% of the population.

  • The practice worked with a care navigator to identify and meet the needs of elderly patients requiring support in their day to day living and with attendance at appointments.

Working age people (including those recently retired and students)

Good

Updated 15 March 2017

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. Patients who completed CQC comment cards complimented the range of electronic services provided.

  • Physiotherapy services were available on site.

  • The practice was a partner in the development of the local care hub that offered 8am to 8pm care seven days a week.

  • Extended hours appointments were available on two mornings and two evenings every week.

People experiencing poor mental health (including people with dementia)

Good

Updated 15 March 2017

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

  • Performance for mental health related indicators was 100%. This was above the CCG average of 95% and national average of 93%. For example, the GPs had agreed care plans with 97% of patients diagnosed with long term mental health problems in the last 12 months. This was better than the CCG and national average of 89%. This performance was achieved with a low exception rate of 2% of the patients compared to the CCG average of 14% and national average of 13%.

  • The practice had developed a dementia café in conjunction with a local care home as a drop in service for patients with dementia and their carers. This was held once a month at the practice and GPs, practice nurses and the care navigator made themselves available to offer advice and support to the patients and their carers.

  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. Close working with the local adult mental health team was in place with this team available in the health centre.

  • The practice carried out advance care planning for patients with dementia. They also offered screening to 214 patients for early dementia that had been accepted by 197 patients in the last 12 months.

  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

  • The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

  • Staff had a good understanding of how to support patients with mental health needs and dementia. The practice is accredited as dementia friendly and was an active member of the local initiative of ‘New Milton Dementia Friendly Town’.

  • There were examples of patients with mental health problems being given additional support to make their appointments.

People whose circumstances may make them vulnerable

Good

Updated 15 March 2017

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 homeless people, travellers and those with a learning disability. Of the 59 patients registered who were diagnosed with a learning disability, 57 had care plans agreed.

  • The practice offered longer appointments for patients with a learning disability.

  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.

  • The practice informed 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.

  • Approximately 3% of the practice population had been identified as holding caring responsibilities. They were offered relevant advice and support by the practice team.