Rockleigh Court Surgery

Updated 18 February 2016

The practice is located above a parade of shops, on the first and second floors, close to Shenfield High Street. It is easily accessible by foot or public transport with free parking for a limited period available immediately outside. Access is via a lift or stairs. The practice has three consulting rooms, one treatment room, a small additional consultation room and two waiting areas.

The practice has approximately 6700 patients. There are four GP partners, three male and one female. They are supported by two practice nurses who work Monday to Friday and a healthcare assistant who works Tuesday mornings and Thursday afternoons. The GPs provide a Saturday morning surgery and rota the duties between themselves.

The practice is open and appointments are available Monday to Friday between 8.30am and 6.30pm. The practice operates extended opening hours on a Saturday and appointments are available from 8.40am to11.45am. The four GPs working hours vary; they are detailed on the practice website.

The practice provide a range of enhanced services such as anti-coagulation monitoring, wound care, admission avoidance, 24 hour blood pressure and heart monitoring, minor injuries, minor surgeries, health checks for patients over 40 years of age and learning disability checks. They also provide NHS and travel vaccinations.

The practice does not provide out of hour’s services. Patients are advised to call the national 111 service who will advise patients of the service they require. Currently their out of hour’s service is provided by IC24 and commissioned by Basildon and Brentwood CCG.

The practice serves an affluent and aging demographic with a higher than national average of patients represented in the over 65 years, over 75years and over 85year group. They also have a higher life expectancy for their patients than the CCG and national averages. Male life expectancy for the practice patients is 82 as opposed to the CCG average of 80 years and the national average 79years. For female patients their life expectancy was 85years above the CCG and national average of 83years.

The area has low levels of deprivation for children and older people when compared to the national averages.

The practice had a comprehensive website detailing opening and appointment times for each of the GPs. There are also details of their patient participation group survey results and health information including signposting to support and specialist services.

Updated 18 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr D P Ainsworth and Partners, also known as Rockleigh Court Surgery on Wednesday 13 January 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 recording and investigating significant events.
• Risks to patients were assessed and well managed. For example, all staff had undertaken appropriate checks prior to being appointed.
• 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 consistently 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 had confidence in the clinical team and found it easy to make an appointment with a named GP. They received continuity of care and urgent appointments were available the same day.
• The practice followed appropriate standards of cleanliness and hygiene. They had good facilities and were well equipped to treat patients and meet their needs, including the provision of specialist services such as a clinic for patients on blood thinning medicines.
• There was a clear leadership structure and staff enjoyed their work and felt supported by management. The practice proactively sought feedback from staff and patients, which it valued and acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The practice was enthusiastic about their clinical work and sought opportunities to improve services to their patients.

The areas where the provider should make improvement are:

• Ensure discussions and decisions relating to learning from complaints and significant incidents are consistently recorded.
• Ensure there is evidence of when, where and how practice rooms had last been cleaned.
• Ensure patient safety data has been appropriately actioned.

Professor Steve Field

(CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice offered proactive care, operating patient recall systems to ensure appropriate checks had been undertaken. Patients receiving a new cancer diagnosis were reviewed within six months.
• Nursing staff had lead roles in chronic disease management and patients at risk of unplanned hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• The practice provided a warfarin clinic to undertake blood tests for thoe patients on blood thinning medicines.
• All these patients had a named GP and a structured annual review to check their health and medicine 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 18 February 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.
• Immunisation rates were high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way. They had access to a range of health literature including advice of how to access specialist services such as the Emotional Wellbeing and Mental Health Service.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice conducted pre-conception counselling for patients hoping to be parents, post natal and post- partum checks (depression and anxiety checks following child birth). They provided advice on antenatal care and worked in partnership with Brentwood Community Hospital midwives to care for their patients.
• They offered health screenings, smear tests, contraception advice and coil removal. The practices uptake for the cervical screening programme was better than the national average achieving 88.72%, as opposed to the national average of 81.83%.

Updated 18 February 2016

The practice is rated as good for the care of older people.

• The practice participated in the admission avoidance programme identifying patients at risk of hospital admission.
• They offered proactive, personalised care in partnership with other health and social care professionals 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.
• Patients were invited for flu and shingles vaccinations (as appropriate).
• Reviews for patients over 75 years included dementia screening.

Updated 18 February 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, operating extended hours opening on Saturday mornings and WebGP (an online service where patients are guided through a series of questions about their concern and signposted to an appropriate service, such as a pharmacist or a GP).

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. For example, the practice offered an online travel immunisation system inviting patients to complete a travel form accessed from their website. Whereby, the practice nurse advised, ordered and administered appropriate vaccinations in accordance with the Department of Health guidelines.

Updated 18 February 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice utilised dementia screening tools in their clinical assessments referring patients where appropriate to the memory clinic or the dementia intensive support team.
• Practice performance for mental health related indicators was better than the national average. For the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in their record in the preceding 12 months the practice achieved 91.67% compared to the national average 88.47%.
• The practices performance was comparable with the national average for the percentage of patients diagnosed with dementia whose care has been reviewed in a face to face review in the preceding 12 months. They achieved 82.98% compared to the national average 84.01%.
• Patients were able to self-refer or be referred into Improved Access to Psychological Therapies.
• Health information was available within the practice for patients interested in accessing various support groups and voluntary organisations.

Updated 18 February 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. Patients with no fixed abode were invited to register as temporary residents to access services.
• The practice offered longer appointments and home visits for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice informed and supported vulnerable patients 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.