• Doctor
  • GP practice

Archived: Dr Andrew Whitfield Also known as Southwood Practice

Overall: Good read more about inspection ratings

Southwood Surgery, Links Way, Farnborough, Hampshire, GU14 0NA (01252) 371715

Provided and run by:
Dr Andrew Whitfield

Latest inspection summary

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Background to this inspection

Updated 6 December 2017

Dr Andrew Whitfield also known as Southwood Practice part of the NHS North East Hampshire and Farnham Clinical Commissioning Group (CCG) and is contracted to provide personal medical services (PMS).

The practice is situated in Farnborough, Hampshire within a multi-use purpose built development. All patient services are offered on the ground floor.

The practice has approximately 6800 patients on its list and is located in a predominantly urban area with mid-range social deprivation. The practice has a young age profile, with approximately 90% of people under 65 years. The practice told us they had a low percentage of patients over 75 years. 3.7 % compared to the England average of 7.8%. The area has a high proportion of working parents, international workers, students and military personnel and families. There is a high turnover of patients with up to 15% of patient’s relocating due to work or house moves. The practice has a low incidence of cancer and other long term conditions compared to the England average.

The practice is owned by the lead GP (male) and employs four female salaried GPs. The nursing team consists of two female practice nurses and one health care assistant who also offer phlebotomy. One of the practice nurses is also an independent nurse prescriber. The clinical team are supported by the practice manager, office manager, secretary, one practice secretary/receptionist and seven receptionists.

The practice had recently recruited a newly qualified salaried GP and was supporting and providing them with clinical supervision to develop general practice skills and knowledge.

The practice is open between 8.30-6.30pm Monday to Friday. Telephone lines were open from 8am. Nurse appointments were available from 8am three days per week and from 8.30am the other two days. GP appointments were available from 8.30am daily. Extended hours surgeries are offered on Tuesday, Wednesday and Thursday evenings until 8.00pm. The practice is closed Saturdays and Sundays.

The practice has opted out of providing out-of-hours services to their own patients. These are provided by the North Hampshire Urgent Care Service (NHUC) and are accessed via the NHS 111 service.

Overall inspection

Good

Updated 6 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Andrew Whitfield (also known as Southwood medical practice) on 4 October 2016, The practice was rated requires improvement overall with an inadequate rating for providing safe services. Areas where the provider needed to make improvements included reviewing the processes for implementing infection control policies, maintaining a good overview of systems and processes to mitigate risk including prescription stationary security and processes around staff administration of vaccines. Additionally, the reviewing and monitoring systems to identify staff training and to review policies and procedures.

We conducted a further comprehensive inspection on 26 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified at our previous inspection on 4 October 2016. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

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

  • Improvements had been made to the monitoring of infection control processes. This included undertaking further infection control audits and reviewing systems to incorporate and monitor actions required.

  • The practice had reviewed strategies for storing and checking of patient group directions (PGDs) and patient specific directions (PSDs). All PGDs were in date and signed by staff authorised to administer vaccines. PSDs were in place for the health care assistant to administer vaccines.

  • The practice had purchased locks for the printers to maintain prescription stationary security and had a process for monitoring these. Security of medicine storage had also been improved with items kept within in locked rooms or in tamper evident sealed boxes.

  • The system for monitoring staff training had been overhauled to ensure it was kept up to date and reflected what training each staff member had completed.

  • All policies within the practice had undergone a review since the last inspection. Each policy had a date for the next review identified on the policy.

  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients we spoke with said they found it easy to get an appointment on the same day and there was continuity of care.
  • 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

There were some areas where the provider continued to need to make improvements:

The provider should:

  • Consider strategies for recording that cleaning of specialist equipment such as couches and blood pressure cuffs have been completed.

  • Review health care waste disposal in line with best practice

  • Continue to review arrangements to identify and support patients who are also carers.

  • Review GP survey results including access to arranging appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 6 December 2017

The practice had resolved issues relating to effective and well-led domains as well as some for the safe domain. The practice is now rated as good for the care of people with long-term conditions.

  • Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

  • The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

  • There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

  • All these patients had a named GP and there was a system to recall patients for 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 6 December 2017

The practice had resolved issues raised at the previous inspection. The practice is rated as good for the care of families, children and young people.

  • From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.

  • Immunisation rates were relatively high for all standard childhood immunisations.

  • Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

  • The practice provided support for premature babies and their families following discharge from hospital.

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

  • The practice worked with midwives to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

  • The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Older people

Good

Updated 6 December 2017

The practice had resolved issues raised at the previous inspection. The practice is now rated as good for the care of older people.

  • Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

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

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

  • The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

  • The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

  • Where older patients had complex needs, the practice shared summary care records with local care services.

  • Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Working age people (including those recently retired and students)

Good

Updated 6 December 2017

The practice had resolved issues raised at the previous inspection. The practice is rated as good for the care of working age people (including those recently retired and students).

  • The needs of these populations 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 and Saturday appointments.

  • 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.

People experiencing poor mental health (including people with dementia)

Good

Updated 6 December 2017

The practice had resolved issues raised at the previous inspection. The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

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

  • The practice had been accredited as a Dementia Friendly practice and amended signage and chair coverings to assist patients with Dementia.

  • The practice specifically considered the physical health needs of patients with poor mental health and dementia.

  • The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

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

  • Patients at risk of dementia were identified and offered an assessment.

  • The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

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

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

People whose circumstances may make them vulnerable

Good

Updated 6 December 2017

The practice had resolved issues raised at the previous inspection. 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.

  • End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

  • 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.

  • Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.