Archived: Woodside Surgery

Updated 30 July 2015

Woodside Surgery provides primary medical services to approximately 4400 patients. The practice is situated in the North Nottinghamshire village of Skegby and is part of the NHS Mansfield and Ashfield clinical commissioning group (CCG). The practice population is predominantly white British with a slightly higher than average number of patients aged over 45 when compared with local and national averages.

The practice is based at a single location with services provided over two floors. Services include midwifery, travel vaccines, immunisations and general medical services. The practice has four GP partners, three male and one female, three practice nurses, one healthcare assistant and an administrative support team. The practice also provides a base for community midwives and health visitors.

The practice is open 8:00am  to 6:30pm Monday to Friday and offers extended appointments to 7:30pm on Monday evenings for both GP and Practice Nurse.

The practice had opted out of providing out-of-hours services to their own patients. This was provided by Central Nottingham Clinical Services.

Updated 30 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woodside Surgery on 11 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for all population groups.

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.
• 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 planned.
• 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.
• 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 the management. The practice proactively sought feedback from staff and patients, which it acted on.

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

Importantly the provider should:

• Carry out a risk assessment for GPs not carrying emergency medicines in their GP home visit bags.
• Ensure that the practice’s whistleblowing policy includes reference to Care Quality Commission (CQC) & NHS England (NHSE) to ensure staff are aware of all agencies they could contact.
• Ensure that all carers are identified on the records system to ensure appropriate information, advice and support for them.
• Carry out appraisals for all staff

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 July 2015

The practice is rated as good for the care of people with long-term conditions. A comprehensive annual review was offered to patients with long term conditions such as, diabetes, asthma, chronic heart disease (CHD) and hypertension (high blood pressure). Where possible reviews were carried out by the same nurse or other clinician to ensure continuity of care for patients. Additional training had been provided to the healthcare assistant to enable them to carry out these annual health checks.

Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments of up to 45 minutes and home visits were available where required. All these patients had a named GP and a structured annual review to check that their health and medication needs were 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.

Updated 30 July 2015

The practice is rated as good for the care of families, children and young people. Although immunisation rates were slightly below the local average for some of the standard childhood immunisations, the practice worked proactively to follow up patients who had missed immunisations for all age groups. For example, young people who missed their 15 year HPV booster or who had chosen not to have their booster through their schools. This service was also offered for young women with their course of HPV vaccinations.

Patients and staff 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 30 July 2015

The practice is rated as good for the care of older people. Patients over the age of 75 had a named GP and home visits for some procedures and health checks were available.

At times of bad weather, home visits were carried out by the practice nurse to patients who may be at risk of fall who required procedures such as dressing changes or blood tests.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people such as rheumatoid arthritis and coronary heart disease. The practice offered proactive, personalised 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. Opportunistic screening and testing was carried out for patients who had concerns about their memory.

The practice monitored patients at risk of hospital admission and worked with local practices and other agencies to maintain a register of these patients.

Updated 30 July 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. For example, extended opening hours were offered on Monday evenings and on weekends before bank holidays.

The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. For example meningitis C catch up vaccinations for students were offered.

Updated 30 July 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 opportunistic memory screening for patients who may have dementia or concerns about their mental health. At the time of our inspection 13 patients were recorded on the mental health register. The practice had achieved all QOF points for this group. Further assessment and referral for these patients was regularly carried out. All staff had undertaken recent dementia awareness training.

Home visits were carried out for health assessments and medication reviews. Patients were able to self-refer to a local counselling service and advice and signposting was offered to other areas of support.

Updated 30 July 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Senior partners had a lead role and additional training for care of patients with learning disabilities and offered tailored support to these patients.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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. Clinical staff were trained in vulnerable adult and child safeguarding. They had also received additional training on the mental capacity act which enabled them to deal effectively with the needs of vulnerable patients. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact the relevant agencies in normal working hours and out of hours.