The Hollies Surgery Also known as Vida Healthcare

Updated 8 May 2015

The Hollies Surgery, in the West Norfolk clinical commissioning group (CCG) area, provides a range of alternative primary medical services to approximately 3600 registered patients living in Downham Market and the surrounding villages. According to Public Health England information, the patient population has a slightly higher than average number of patients under 18 years of age compared to the practice average across England. It has a slightly higher proportion of patients aged over 65, 75 and a slightly higher than average number of patients aged over 85 compared to the practice average across England. Income deprivation affecting children and older people is slightly lower than the practice average across England.

The Hollies is provided by Vida Healthcare, a partnership made up of 20 partners who hold financial and managerial responsibility for six GP practices in Norfolk. At The Hollies Surgery there is a GP partner, a salaried GP and a long term locum GP, seven nurses, two health care assistants and a number of receptionists and administration staff. There is also a management team which includes a practice manager, a head of patient’s services, a head of people and governance and a head of finance. The practice is a training practice for medical students and qualified doctors who are training to be GPs.

The practice provides a range of clinics and services, which are detailed in this report, and operates between the hours of 08:00am and 18:30pm, Monday to Friday with extended hours until 19:00pm on a Monday and a Thursday. Outside of practice opening hours a service is provided by another health care provider (Medicom) by patients dialling the NHS 111 service.

Updated 8 May 2015

Letter from the Chief Inspector of General Practice

We visited The Hollies Surgery on the 22 January 2015 and carried out a comprehensive inspection. We found that the practice provided a safe, effective, caring, responsive and well led service. The overall rating for this practice is good.

We examined patient care across the following population groups: older people; those with long term medical conditions; families, babies, children and young people; working age people and those recently retired; people in vulnerable circumstances who may have poor access to primary care; and people experiencing poor mental health. We found that care was tailored appropriately to the individual circumstances and needs of the patients in these groups.

Our key findings were as follows:

• Patients were satisfied with the appointment system and felt they were treated with dignity, care and respect. They were involved in decisions about their care and treatment and were happy with the care that they received from the practice.

• The practice was friendly, caring and responsive. It addressed patients’ needs and worked in partnership with other health and social care services to deliver individualised care.

• The needs of patients were understood and services were offered to meet these.

• The practice effectively used the benefits of being part of a large partnership, whilst retaining the individuality of being a small practice.

• There were a number of clinical teams who specialised in different areas, in order to provide a focussed and effective service to patients.

We saw some areas of outstanding practice:

• The practice offered dementia screening for patients with Down's Syndrome who were aged over 40 years of age.

• The practice worked well with their patient representative group. There was evidence that they provided external oversight and scrutiny in relation to complaints and significant events. A patient representative was also on the interview panel for the Chief Executive Post.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 May 2015

The practice is rated as good for the population group of people with long term conditions. The practice had a specialist clinical team for a range of long term conditions including diabetes, asthma and chronic obstructive pulmonary disease (COPD). Each team had a GP lead and the team met regularly to organise the care and treatment of patients, share good practice and review their performance. All patients with long term conditions had structured reviews, at least annually, with most patients being recalled for a review every nine months to check their health and medication needs were being met. Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed, longer appointments and home visits were available . For those people with the most complex needs the GPs and nurses worked with relevant health care professionals to deliver a multidisciplinary package of care.

Updated 8 May 2015

The practice is rated as good for the population group of families, children and young people. Patients told us, and we saw evidence that, children and young people were treated in an age appropriate way and recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. We were provided with good examples of joint working with health visitors. Immunisation rates were relatively high for all standard childhood immunisations. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health.

Updated 8 May 2015

The practice is rated as good for the care of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. Patients over the age of 75 had a named GP who was responsible for the coordination of their care. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example in dementia and end of life care. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs.

Updated 8 May 2015

The practice is rated as good for the population group of working-age adults (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 offer continuity of care. The practice offered extended hours appointments on two evenings a week. Patients could book appointments in a range of ways to meet their circumstances. These included being able to book appointments any time of the day either on line, or via an automated telephone booking line. The practice offered telephone consultations as well as a full range of health promotion and screening which reflected the needs for this population.

Updated 8 May 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). Nationally reported data showed the practice had above average outcomes for people with mental health needs, including those with dementia. The practice ran a clinic with the Norfolk Recovery Partnership to ensure that patients with drug and alcohol needs received appropriate support. Patients could also be referred by a GP and seen at the mental health clinic which was held at another Vida Healthcare practice in the local area. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. We were told that dementia screening was undertaken, which included proactive screening for patients with Downs Syndrome who were over the age of 40. Depending on the results, patients were referred to the local dementia specialist centre for further assessment. The practice had advance care planning in place for patients with dementia.

Updated 8 May 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. Nationally reported data showed the practice performed above the clinical commissioning group (CCG) and England average for people with a learning disability. The practice held a register of patients with a learning disability and 75% had received an annual health checks. Annual health checks were undertaken in the patient’s own home, if necessary, for example if they were too anxious to have this completed at the practice. A process was in place to follow up patients who had not attended for their appointment.

We were told that longer appointments were given to patients who needed more time to communicate during a consultation, for example people who needed an interpreter. There were arrangements for supporting patients whose first language was not English.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours.