The Puckeridge Surgery Also known as Standon & Puckeridge Surgery

Updated 11 April 2016

The Standon and Puckeridge Surgery is one of two registered locations operated by the Buntingford and Puckeridge Medical Practice, which provides primary medical services, including minor surgery, to approximately 8183 patients from premises at Station Road, Puckeridge, Hertfordshire.

The practice serves a lower than average population for those aged between 20 to 39 years, and higher than average population of those aged between 40 to 69 years. The population is 97% White British (2011 Census data). The area served is less deprived compared to England as a whole.

The practice team consists of four GP partners and two salaried GPs. Two GPs are male and four are female. There are two practice nurses, one healthcare assistant a practice manager and 11 administration and reception staff.

The practice is open to patients between 8.30am and 6pm Monday to Friday. Appointments with a GP are available from 8.30am to 10.30am and from 3.30pm to 5.30pm Monday to Friday. The practice offers extended opening hours between 6.30pm to 7.30pm every Monday and Wednesday. Emergency appointments are available daily with the duty doctor. A telephone consultation service is also available for those who need urgent advice. Home visits are available to those patients who are unable to attend the surgery and the practice is also able to offer home visits via the Acute In Hours Visiting Service. This is a team of doctors who work across East and North Hertfordshire to visit patients at home to provide appropriate treatment and help reduce attendance at hospital. The out of hours service is provided by Hertfordshire Urgent Care and can be accessed via the NHS 111 service. Information about this is available on the practice website and telephone line.

Updated 11 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Standon and Puckeridge Surgery on 3 February 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 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.
• Patients said they found it easy to make an appointment 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 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.

The areas where the provider should make improvement are:

• Review medicines stock control procedures to ensure medicines are within the expiry date recommended by the manufacturers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 April 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.  GPs provided enhanced services for near patient testing for Disease Modifying Anti-Rheumatic Drugs (DMARDs).  Nurses would conduct home visits to offer flu vaccinations and annual health checks for people with long term conditions.  Performance for diabetes related indicators was comparable with the local Clinical Commissioning Group (CCG) and national averages.  Longer appointments and home visits were available when needed.  All patients with a long-term condition had a named GP and 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. 

Updated 11 April 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.  75% of patients diagnosed with asthma, on the register, had received an asthma review in the last 12 months.  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 in line with the national average 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 nurses from a local hospice.

Updated 11 April 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, this included enhanced services for dementia and end of life care.  The practice was responsive to the needs of older people, and offered home visits and urgent appointments when required.  The practice had completed 374 health checks for patients aged over 75 in the last 12 months, which was 57% of this population group.  Flu vaccination rates for patients aged over 65 were comparable with the national average.  The practice worked closely with a rapid response service in place to support older people and others with long term or complex conditions to remain at home rather than going into hospital or residential care.

Updated 11 April 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.  It provided a health check to all new patients and carried out routine NHS health checks for patients aged 40-74 years.  The practice was proactive in offering online services such as appointment booking and repeat prescriptions services, as well as a full range of health promotion and screening that reflects the needs for this age group.  It offered an appointment reminder text messaging service and appointment times were extended until 7.30pm every Monday and Wednesday.

Updated 11 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 88% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in 2014/2015, which was higher than the national average.  The practice carried out advance care planning for patients with dementia.  It held a register of patients experiencing poor mental health and offered regular reviews and same day contact.  Weekly visits to a local residential home for people experiencing poor mental health were carried out by a named GP for continuity of care and emergency visits were also provided when needed.  The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.  Patients were referred to a counselling service which was provided at the practice three times a week.  The practice had a system in place to follow up patients who had attended accident and emergency 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 11 April 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.  It offered longer appointments and annual health checks for people with a learning disability.  The practice held a register of carers, there was a nominated carer’s champion who was proactive in offering health checks, flu vaccinations and information and advice about local support groups and services were also available.  The practice had a system in place to identify patients with a known disability.  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 had received safeguarding training and 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.