Catterick Village Surgery

Updated 23 December 2016

Catterick Village Surgery is a GP practice in Catterick Village, Richmond, North Yorkshire. The practice has a Personal Medical Services (PMS) contract and also offers a range of enhanced services. There is a branch surgery at Colburn Village. The practice covers Catterick and the surrounding villages. The practice has a large number of ex-military personnel and military families registered. The building is owned by NHS property services.

There are three GP partners, two male and one female, a practice manager, office manager, nurse manager (female), three practice nurses (all female), two health care assistants( both female), six receptionists, one cleaner and one secretary. The practice has a patient list size of approximately 6500 patients. The practice is a teaching and training practice and currently trains registrars, Foundation stage two doctors and 5th year medical students.

The practice is open between 8am and 6pm Monday to Friday with extended appointments offered on different evenings each week from 6.30pm to 9.30pm. They offer a mixture of pre-bookable and drop-in clinics.

The daily drop in clinics are at alternative sites between 9.30am and 10.30am every morning. Pre-bookable appointments are available daily between 8.30am and 11am every morning and 2.30 pm to 5pm every afternoon. They also have GP bookable slots for follow up appointments, medicals etc. between 8am and 9.30am daily.

The branch site at Colburn was not visited during this inspection.

Updated 23 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Catterick Village Surgery on 22 November 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• The practice participated in the Community Nursing Project in conjunction with the CCG, this enabled trained staff to visit care homes in order to provide training to care home staff and provide long term condition care, advanced care planning and unplanned admissions avoidance.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments and telephone consultations 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 however the practice had gone through a period of unsettlement due to long term sickness absence of two key members of staff. Some staff felt unsupported by management. The practice was aware of this and had implemented measures to address it.
• 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.

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.

• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less (01/04/2015 to 31/03/2016) was 80% which was comparable with local figures of 83% and the same as national figures.

• The percentage of patients with diabetes, on the register, in whom the last HbA1c was 64 mmol/mol or less in the preceding 12 months (01/04/2015 to 31/03/2016) was 77% which was comparable with local figures of 80% and national figures of 78%.

• 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 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 recorded that a cervical screening test had been performed in the preceding 5 years (01/04/2015 to 31/03/2016) was 94% which was above local figures of 84% and national figures 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.

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 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.

• Weekly visits were made to local care homes by a dedicated GP.

• Practice nurses provided care to care home residents with regard to long term conditions care, advanced care planning and avoidance of unplanned admission to hospital.

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 with dementia).

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2015 to 31/03/2016) was 96% which was above the local and national average.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. The branch surgery at Colburn shared the building with staff from specialist mental health services which facilitated effective information sharing.

• The practice carried out advance care planning for patients 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 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 travellers and those with a learning disability.

• Vulnerable patients were given priority during open access clinics to avoid prolonged waiting times.

• The practice offered longer appointments for patients with a learning disability.

• The practice area provided care to two supported living homes occupied by patients with a learning disability and had a lower threshold for home visits for these patients.

• 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. For example the practice signposted patients to Phoenix House, a recovery centre for Armed forces personnel.

• 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.