Dr Coulson and Partners

Updated 25 April 2016

Dr Coulson & Partners is a GP practice which provides primary medical services under a Personal Medical Services (PMS) contract to a population of approximately 17, 300 patients living in the Wellingborough area in Northamptonshire. A PMS contract is a locally agreed alternative to the standard General Medical Services (GMS) contract used when services are agreed locally with a practice which may include additional services beyond the standard contract.

The practice operates from a modern, well-equipped, three storey premises, with disabled access including access to all floors via a lift. Consultations take place on the first and second floors and there are spacious waiting areas on each floor. There is also a branch practice known as Wollaston Branch Surgery, St Michael's Lane, Wollaston, Northamptonshire, which opens for GP consultations. Minor surgery is only carried out in the main surgery. The branch surgery was not inspected as part of this process.

The practice population has a higher than average number of patients aged 0 to 10 years and 25 to 35 years and national data indicates that the area has moderate levels of deprivation. The practice population is made up of predominantly white British, with an increasing number of Asian and eastern European patients.

There are eight GP partners, three female and five male, and the practice employ five practice nurses, a nurse practitioner, a health care assistant and a practice manager, who are supported by a team of administrative and reception staff. It is a teaching and training practice which provides training and support to qualified doctors who are training to be GPs as well as occasional medical students. They are also committed and involved in a variety of research and development projects and have been for many years.

The main practice is open daily Monday to Friday between 8.30am and 6pm and Saturday from 8am until 12 midday. The branch practice at Wollaston is open Monday from 3pm until 5.30pm and Tuesday, Thursday and Friday from 9am until 11.30pm.  When the surgery is closed services are provided by an out of hours provider who can be contacted via the service via NHS 111.  

Updated 25 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Coulson and Partners practice on 9 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 with urgent appointments available the same day, although getting an appointment with a preferred GP was more difficult.
• 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:

• To consider more formal meetings involving all staff in the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 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.
• The practice offered a ‘one stop’ appointment to review multiple conditions at one appointment.
• Longer appointments and home visits were available when needed.
• All these patients had 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 25 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 high for all standard childhood immunisations.
• The number of patients diagnosed with asthma who had had an asthma review in the last 12 months was 82% which was above the national average.
• 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.
• 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 and health visitors.

Updated 25 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.

• A GP attended the allocated local care homes weekly to carry out ward rounds.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs as well as longer appointments if required.

• Patients were encouraged at consultations to take up flu vaccinations.

Updated 25 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. For example the practice opened on Saturdays to enable those patients who were at work during the week to access the services.
• 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 25 April 2016

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

• 84% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia and carried out dementia assessment and referral to the memory clinic.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• They 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.
• They employed a councillor to allow them to refer for support as necessary.

Updated 25 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.
• There was a flagging system to alert staff to patients with issues such as drug problems or alcohol abuse in families.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.