Archived: West Town Surgery

Updated 16 May 2017

West Town Surgery occupies a Grade 2 listed building in the centre of Barton-upon Humber, North Lincolnshire. They have a Primary Medical Services (PMS) contract and also offer enhanced services, for example, childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for people with dementia, risk profiling and case management and unplanned hospital admissions. They are a dispensing practice so can dispense medications to patients in rural communities who do not have reasonable access to a community pharmacy.

There are 3030 patients on the practice list and the majority of patients are of white British background. The practice population profile is similar to that for England except the 0-44years age group is lower than the England average and the 45-75 years age group is slightly higher than the England average. The practice scored seven on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. The overall practice deprivation score is lower than the England average, the practice is 18.1 and the England average is 21.8 People living in more deprived areas tend to have a greater need for health services.

The practice is a training practice for year two medical students.

The practice has one female GP and a long term locum male GP. There is a practice nurse and a practice manager along with four administration/ reception staff.

The practice is open Monday to Friday from 8am -6.30pm. It closes from 12.30pm -1.30pm during which only urgent messages may be left.

GP appointments are available:

Monday 8am - 12.30am and 1.30pm - 6pm

Tuesday 8am - 12.30am and 1.30pm - 6pm

Wednesday 8am - 12.30am and 1.30pm - 6pm

Thursday 8am - 12.30am and 1.30pm - 6pm

Friday 8.am - 12.30am and 1.30pm - 6pm

The practice is closed every second Wednesday afternoon for staff training.

The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed, patients’ calls are transferred to the Out Of Hours provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area.

Updated 16 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 2 June 2016. A breach of legal requirements was found. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

Regulation 17 HSCA (RA) Regulations 2014 Good governance

How the regulation was not being met:

Recruitment checks for some staff had not been carried out prior to them commencing employment at the practice.

Minimum, maximum and actual temperatures of the medicines refrigerator were not recorded daily when the practice was open.

The results of the dispensing audit had not been acted upon.

Checking of dispensary stock expiry dates did not meet with the recommendations made in national guidance and staff did not always record when checks were made.

This inspection was a desk-based review carried out on 2 March 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 in our previous inspection on 2 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The full comprehensive report on the Month Year inspection can be found by selecting the ‘all reports’ link for West Town Surgery on our website at www.cqc.org.uk.

Overall the practice is rated as good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 August 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.
• 88% of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 64 mmol/mol or less in the preceding 12 months is comparable to the CCG average of 77% and the national average of 78%.
• 87% of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less is comparable to the CCG and national averages of 78%.
• 96% of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months is comparable to the CCG average of 87% and the national average of 88%.
• 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 the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 1 August 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 81% which was comparable to the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 1 August 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.

Updated 1 August 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 81% which was comparable to the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 1 August 2016

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

Performance for mental health related indicators was better than the national average, for example;

• 97% of patients with psychoses had a comprehensive, agreed care plan compared to the national average of 88%
• 97% of patients with psychoses have had their alcohol consumption recorded compared to the national average of 90%
• 80% of patients diagnosed with dementia have documented care plans and had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%
• The practice carried out advanced care planning for patients with dementia.
• The practice visited a local psychiatric care unit to undertake annual reviews and had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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 1 August 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 various support groups and voluntary organisations.
• 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.