Milton Keynes Village Surgery Also known as Milton Keynes Village Practice

Updated 25 October 2016

Milton Keynes Village Surgery provides a range of primary medical services, including minor surgical procedures from its location on Griffith Gate, Middleton in Milton Keynes.

The practice serves a predominantly White British population of approximately 13,700 patients, with gradually increasing populations of Ethnic minority patients from Eastern Europe and Asia, There are higher than average populations of males and females aged 0 to 19 years and 25 to 49 years, demonstrating a high working age population. There are lower than average populations of patients aged 20 to 29 years and 50 years to 85 years and over. National data indicates the area is one of low deprivation and low unemployment in comparison to England as a whole.

The clinical team consists of four male and two female GP partners, a nurse partner, a minor illness nurse, two practice nurses, a health care assistant and a phlebotomist. The team is supported by a practice manager and a team of administrative staff. The practice holds a General Medical Services (GMS) contract for providing services, which is a nationally agreed contract between general practices and NHS England for delivering general medical services to local communities.

The practice is a training practice with two accredited GP trainers and two GP registrars (registrars are qualified doctors training to become GPs).

The practice operates from a two storey purpose built property and patient consultations and treatments take place on the ground level. There is a car park surrounding the surgery shared with the neighbouring pharmacy and dental practice, with designated disabled parking available.

Milton Keynes Village Surgery is open between 8am and 6.30pm Monday to Friday. In addition, pre-bookable appointments are available from 7am Thursdays and between 6.30pm and 8pm on Mondays and Thursdays.

The out of hours service is provided by Milton Keynes Urgent Care Services and can be accessed via the NHS 111 service. Information about this is available in the practice and on the practice website and telephone line.

At the time of our inspection, the registration of Milton Keynes Village Surgery with CQC to provide regulated activities was not accurate and the practice was not registered to carry out regulated activities for surgical procedures, as required under the CQC (Registration) Regulations 2009. Prior to our inspection the practice submitted an application to provide these services to ensure their registration with us is accurate.

Updated 25 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Milton Keynes Village Surgery on 13 September 2016. 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.
• 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.
• The practice operated a personal list system and 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 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.

We saw one area of outstanding practice:

• The practice was classed as a POCT (point of care testing) hub practice within the locality, and alongside six other practices was offering patients additional services not normally found within a GP setting. The practice was able to offer patients BNP testing for signs of heart failure. The practice was able to receive referrals from other practices across the locality to provide these services to patients outside their own practice population.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 October 2016

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 comparable to the Milton Keynes Clinical Commissioning Group (CCG) and national averages. For example, the percentage of patients with diabetes, on the register, in whom the last blood pressure reading was 140/80 mmHg or less (in the preceding 12 months) was 88%, where the CCG average was 76% and the national average was 78%.
• 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 more complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 25 October 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, 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 83%, which was comparable to the CCG average and national averages of 82%.
• 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, health visitors and school nurses.
• Family planning and contraceptive advice was available.

Updated 25 October 2016

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.
• The practice supported registered frail elderly patients in a local nursing home.
• The practice provided influenza, pneumonia and shingles vaccinations.
• An in-house phlebotomy clinic ran daily enabling patients to have blood tests conducted locally rather than at the local hospital.
• All patients over the age of 75 had a named GP.

Updated 25 October 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 and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice provided health checks to all new patients and carried out routine NHS health checks for patients aged 40-74 years.
• Pre-bookable appointments were available from 7am on Thursdays and between 6.30pm and 8pm on Mondays and Thursdays.
• Telephone consultations were available daily.
• The practice had enrolled in the Electronic Prescribing Service (EPS) in 2015. This service enabled GPs to send prescriptions electronically to a pharmacy of the patient’s choice.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

Updated 25 October 2016

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

• The percentage of patients with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months (01/04/2014 to 31/03/2015) was 96% where the CCG average was 78% and the national average was 84%.
• All staff had received dementia awareness training.
• Performance for other mental health related indicators were above local and national averages. For example, the percentage of patients with diagnosed psychoses who had a comprehensive agreed care plan was 97% where the CCG average was 86% and the national average was 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended A&E 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.

Updated 25 October 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 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.
• The practice informed vulnerable patients about how to access support groups and voluntary organisations.
• The practice held palliative care meetings in accordance with the national Gold Standards Framework (GSF) involving district nurses, GP’s and the local Willen Hospice nurses.
• 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.
• The practice had identified just less than 1% of the practice list as carers. The practice were making efforts to identify and support carers in their population.
• A member of staff had been trained as a Carers Champion.