Archived: Selston Surgery

Updated 10 April 2017

Dr Shashi Bassi is a single handed male GP who manages Selston Surgery at 138, Nottingham Road, Selston, Nottinghamshire. He provides primary medical services to approximately 4,800 patients in the Selston area. The practice population includes 20% of patients aged 65 years and over.

• The staff team includes six administrative staff, an apprentice administrator, a practice manager, an assistant practice manager, two nurse practitioners, a practice nurse, two health care assistants and a male GP. Three male locum GPs also provide medical support to the practice.

• The arrangements for seeing a female clinician includes two female advanced nurse practitioners.

• The practice holds a Primary Medical Services (PMS) contract to deliver personal medical services.

• The practice is open between 8am and 6.30pm Monday, Tuesday and Friday. On Wednesday it is open from 8am until 1pm, and on Thursday it is open from 6.45am until 8pm to accommodate extended appointments and consultation times. Patients can also access telephone consultations and a ‘drop in’ service for minor issues, where an appointment is not required, between 8am and 9.30am Monday to Friday. They can also access a walk in service on a Wednesday evening from 6.30pm to 8.30pm, and Saturday mornings from 9am to 12.30pm at a nearby Health Centre, which is run by local GPs. This enables patients to see a local GP outside of the practice’s opening hours.

• The practice does not provide out-of-hours services to the patients registered there. During the evenings, at weekends and after 1pm on Wednesday an out-of-hours service is provided. Contact is via the NHS 111 telephone number.

• The practice lies within the NHS Mansfield and Ashfield Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

• The practice was inspected in July 2015 and was rated good overall, however was found to be requires improvement for providing safe services. Breaches in regulation 12 safe care and treatment were identified and requirement notices were issued.

Updated 10 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Selston Surgery on 14 July 2015. The overall rating for the practice was good however the practice was rated as requires improvement for providing safe services. The full comprehensive report on the July 2015 inspection can be found by selecting the ‘all reports’ link for Selston Surgery on our website at www.cqc.org.uk.

This inspection was undertaken and was an announced comprehensive inspection on 23 February 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• A system was in place for acting on patient safety alerts and we found significant events were reported, recorded and investigated.

• Lessons learnt were recorded as a result of incidents however these were only discussed with staff involved until the annual review.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• There was evidence of appraisals and personal development plans for all staff. However, the staff had not had an appraisal in the last 12 months. This had been identified by the practice and plans were in place for these to be booked.

• Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

• We observed staff members were courteous and very helpful to patients and treated them with dignity and respect.

• Patients could access telephone consultations and a ‘drop in’ service for minor issues, where an appointment was not required, between 8am and 9.30am Monday to Friday. They could also access a walk in service on a Wednesday evening from 6.30pm to 8.30pm, and Saturday mornings from 9am to 12.30pm at a nearby Health Centre, which was run by local GPs.

• Feedback from residential homes included that the reception staff were helpful, courteous and polite.

• The provider was aware of and complied with the requirements of the duty of candour.

• The practice encouraged and valued feedback from patients, the public and staff.

• The practice had a patient participation group which was actively involved in patient education and improvement work in liaison with practice staff.

The areas where the provider should make improvement are:

• Consider adding governance agenda items to staff meetings such as significant events, safety alerts, NICE guidance and audit, to ensure that these are always shared with all staff.

• Consider reviewing the storage of policies and procedures to make them more accessible to staff.

• Safeguarding meetings should be formalised with minutes for information to those unable to attend, such as health visitors.

• Continue to book and carry out appraisals on an annual basis.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 April 2017

The practice is rated as good for the care of people with long-term conditions.

• Staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The practice had nurse led chronic disease appointments for routine reviews

• Performance for diabetes related indicators was comparable to CCG and national averages. (89% compared to 85% CCG average and 90% national average).
• Longer appointments and home visits were available when needed.
• The practice worked with community specialist nurses for heart failure, complex diabetic patients and chronic obstructive pulmonary disease patients.

Updated 10 April 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.

• The practice had an effective immunisation service and non-attenders were followed up.

• 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 81%, which was comparable to the CCG average 84% and national average of 81%.

• We saw positive examples of joint working with midwives and health visitors although the face to face meetings with the health visitor had not happened since 2016 when a new health visitor had been assigned to the practice.

Updated 10 April 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 main care home was contacted weekly by the lead GP and the GP and HCA attended to review patients registered with the practice. Feedback from the care home said that at times the GP consulted over the telephone rather than attending.

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

• Reviews were completed in patients home were required.

• The practice worked with the multi-disciplinary teams in the care of older vulnerable patients.

Updated 10 April 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 and flexible.

• Patients could access a ‘drop in’ service for minor issues, where an appointment was not required, between 8am and 9.30am Monday to Friday. They could also access a walk in service on a Wednesday evening from 6.30pm to 8.30pm, and Saturday mornings from 9am to 12.30pm at a nearby Health Centre, which was run by local GPs.

• Telephone consultations were available.

• 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.

Updated 10 April 2017

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

• 74% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was below the CCG average of 87% and the national average of 84%. The practice were aware of this and had already completed 74% for this year. Outstanding patients were on a report ready to be called for review.

• 95% of patients experiencing poor mental health were involved in developing their care plan in last 12 months which was better than the national average of 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

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

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 10 April 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 those with a learning disability.

• 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.

• 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.