Archived: The Chaucer Surgery

Updated 21 March 2016

The Chaucer Surgery is located in Nuneaton and provides primary medical services to patients in an urban and semi-rural area. This largely comprises the Attleborough and Whitestone areas of the town. The practice moved to its current location in 2002 and has been managed by Malling Health since April 2015. It has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice is located in a purpose built building and has 2,800 patients registered. This includes 45 patients in two local dementia care homes. The local area has some pockets of deprivation and a higher than average number of older people, with over 7% of patients registered at the practice being aged over 75.

The practice is staffed by a lead salaried GP (male) who is also the lead GP for the other three Malling Health GP practices located in the Warwickshire North Clinical Commissioning Group (CCG). There is a salaried GP and two locum GPs who are permanently based at the practice who provide a mix of male and female GP care. Other clinical staff include a practice nurse and a healthcare assistant. They are supported by a practice manager and administrative and reception staff. The practice had started a recruitment exercise for a permanent salaried GP to reduce the need of the use of regular locum GPs.

The Chaucer Surgery opens from 8am to 6.30pm during the week. Appointments are available from 8.40am to 10.40am and from 3pm to 5pm (4pm to 5.30pm on Thursdays). Telephone consultations are available by arrangement for patients who are unable to attend the practice during these times. The practice is investigating whether there is a need for extended hours opening and is considering applying for this provision for 2016-2017. When the practice is closed, patients can access out of hours care through NHS 111. The practice has a recorded message on its telephone system to advise patients of this facility. This information is also available on the practice’s website and in the patient practice leaflet.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice.

The practice treats patients of all ages and provides a range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease. Other appointments are available for services such as family planning and smoking cessation. 

Updated 21 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Chaucer Surgery on 15 December 2015. Overall the practice is rated as good for providing safe, effective, caring, responsive and well led services.

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

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. Staff resources were shared with other practices in the group to enable practices to support each other and share best practice. The practice was looking at ways to develop this further and had started a staff skills analysis to facilitate this.

• There was a clear leadership structure and staff felt supported by management. The practice was supported by Malling Health’s (the group) regional management team

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The practice used a Critical Event Toolkit which linked significant events to requirements under the Quality and Outcomes Framework (QOF) to ensure that standards were maintained and safety was not compromised.

• The practice had good facilities and was well equipped to treat patients and meet their needs. The practice proactively sought feedback from staff and patients, which it acted on to improve systems and processes..

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

However there were areas of practice where the provider should make improvements. The provider should:

• Review the process for handling verbal complaints to ensure all complaints are dealt with appropriately.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 March 2016

The practice is rated as good for the care of people with long-term conditions. The practice had systems in place to monitor patients with chronic diseases. Patients at risk of hospital admission were closely monitored. Longer appointments and home visits were available when needed. Patients were reviewed at least annually, sometimes more frequently depending on the condition they had and its severity. All patients diagnosed with a long term condition had a named GP and a structured annual review to check that their health and medicine needs were being met. Patients were encouraged to discuss anything relating to their condition at any time with a member of the clinical staff, rather than wait until their next review. For those patients with the most complex needs, the GP and practice nurse worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 21 March 2016

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 of abuse. For example, children and young people who had a high number of accident and emergency (A&E) attendances.

The practice worked with the locally based community midwife and health visitor teams. A GP and the practice manager met with a health visitor weekly to discuss any concerns. The practice had a policy of providing same day appointments for children and appointments were also available outside of school hours. The premises were suitable and accessible for children, with changing facilities for babies. The practice contacted parents when babies and children failed to attend for their vaccinations and informed Child Health Services when appropriate. The practice also offered online services which included booking appointments and requesting repeat medicines.

Updated 21 March 2016

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 effective, personalised care to meet the needs of the older people in its population. It was responsive to the needs of older people and offered home visits for those unable to reach the practice. GPs also made proactive visits to two dementia care homes where patients lived. Health checks were carried out for all patients over the age of 75 years. At the time of our inspection, the practice had implemented its 2015-2016 flu vaccination programme. The practice worked with the local Clinical Commissioning Group (CCG) to care for a number of patients in other local homes under an avoiding unplanned hospitals admissions scheme.

Updated 21 March 2016

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. Telephone consultations were available for patients who were unable to reach the practice during the day. The practice was investigating whether there was a need for extended hours opening and was considering applying for this provision for 2016-2017. The practice offered online services as well as a full range of health promotion and screening services that reflected the needs for this age group. The practice nurse had oversight for the management of a number of clinical areas, including immunisations.

Updated 21 March 2016

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, for example, the community mental health team, to plan care and treatment with patients who experienced poor mental health, including those with dementia. It carried out advanced care planning and annual health checks for patients. The GPs and practice nurse understood the importance of considering patients’ ability to consent to care and treatment and dealt with this in accordance with the requirements of the Mental Capacity Act 2005.

The practice had advised patients experiencing poor mental health how to access various support groups and voluntary organisations, for example, the Improving Access to Psychological Therapies team (IAPT). There was also a system in place to follow up patients who had attended accident and emergency (A&E). Staff had received training on how to care for people with mental health needs and dementia.

Updated 21 March 2016

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 patients with a learning disability. An alert was placed on their computerised patient record to inform practice staff of the patient’s circumstances so they could be treated appropriately. The practice carried out annual health checks and offered longer appointments for patients in this category when needed.

We saw how the practice regularly worked with multi-disciplinary teams, for example the community mental health team and district nursing team in the case management of vulnerable people. Vulnerable patients were referred or signposted to local support groups and voluntary organisations when appropriate. Patients who frequently attended accident and emergency (A&E) were identified and closely monitored.

Staff had received appropriate training and knew how to recognise signs of abuse in adults whose circumstances made them vulnerable and children who were considered to be at risk of harm. Staff were aware of their responsibilities to document concerns, share information and contact relevant agencies.

A number of homeless patients and patients from the travelling community were registered at the practice to enable them to access NHS services.