Gudge Heath Lane Surgery

Updated 23 December 2016

Gudgeheath Lane Surgery, 187 Gudgeheath lane, Fareham Hampshire PO15 6QA is situated on the edge of a large town location close to shops and public transport links.

The practice is located in a building which was originally two bungalows, now joined together and extended and adapted for healthcare. There is one large reception area on the ground floor with one parking space outside for patients requiring disabled access.

There are six clinical rooms on the ground floor, all of which are wide enough for wheelchair access.

The first floor has offices and a conference room for meetings. Breastfeeding is promoted by staff who offer women a room if they require privacy.

The practice provides general medical services to 8,400 patients with only 8% aged over 75. Around 80% of the registered practice population is under 65 years of age such as families and young people. The practice population has less than 10% of mixed ethnicity and is mostly recognised as White British. The practice is located in one of the least deprived parts of the country.

There are currently two male and four female GPs, who provide the equivalent of four whole time GPs. This is made up of four partners who undertake six sessions per week each and two partners who undertake four sessions per week. The practice has one long term locum covering a sabbatical for the senior GP. There is a nursing team with three practice nurses, equivalent to 1.4 whole time nurses

Gudgeheath Lane Surgery supports medical students and student nurses with their training in association with Southampton and Portsmouth Universities.

The practice is supported by an administration team of a practice manager and 18 part time administrative staff.

The practice is open between 8am and 6.30pm Monday to Friday.

Extended hours appointments are offered once a week, on different days until 8.45pm. They were bookable up to four weeks in advance, advertised in the reception, on the website and via newsletter.

Patients are directed to use the NHS 111 system when the practice is closed. There has been no previous CQC inspection at this location.

Updated 23 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Gudgeheath Lane Surgery on 4 October 2016. Overall the practice is rated as good.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 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.
• 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 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 practice demonstrated consistent staff engagement using different methods, with a variety of forums for listening to staff. They made staff feel valued by using a well-being at work questionnaire for staff every year and created an action plan based on the results.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 December 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.
• A specialist respiratory nurse was employed to deliver four sessions per month for patients with chronic lung diseases.
• Performance for diabetes related indicators were similar to national averages. For example, the percentage of patients with diabetes, on the register, in whom the last average blood sugar test was acceptable, was 96% which was higher than the national average of 78%. However, the exception rate in this area was 31%. This was higher than the CCG average of 15% and the national average of 8%.
• 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 23 December 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 Accident and Emergency (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 percentage of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding five years was 81%. This was comparable to a CCG average of 84% and 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 school nurses. The practice met with these professionals on a monthly basis to ensure the health needs of this group were met.

Updated 23 December 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 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 held meetings with local community healthcare staff every three months, to ensure they were able to follow Gold Standard Framework end of life care guidelines.

Updated 23 December 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 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 23 December 2016

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

• 84% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was comparable to a CCG average of 85% and a national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice carried out advance care planning for patients living with dementia.
• The practice 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 those living with dementia.

Updated 23 December 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 homeless patients, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• 95% of patients with a learning disability received a health check in the last year, one patient declined.
• 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.