The Orchard Partnership, The Old Orchard Surgery

Background to this inspection

Updated 19 May 2017

The Orchard Partnership, The Old Orchard Surgery operates across four surgeries on the southern edge of Salisbury Plain in Wiltshire. It is one of the practices within the Wiltshire Clinical Commissioning Group and has approximately 10,800 patients.

The area the practice serves has relatively low numbers of people from different cultural backgrounds and is in the low range for deprivation nationally, (although it is important to remember that not everyone living in a deprived area is deprived and that not all deprived people live in deprived areas). The practice has a higher than average number of patients over 40 years old.

The practice provides a number of services and clinics for it’s patients including childhood immunisations, family planning, minor surgery and a range of healthly lifestyle management and advice including asthma management, diabetes, heart disease and high blood pressure management; travel immunisations, advice on weight, diet and smoking cessation.

There are eight GP partners and two salaried GPs, four male and six female, making a full time equivalent of seven doctors. They are supported by eight practice nurses, five health care assistants and an administrative and dispensing team of 37 staff led by the practice manager.

The three branch surgeries are up to 12 miles from the main surgery and operate relatively independently in relation to staff and opening hours which are detailed on the practice website. The main surgery in Wilton is open between 8am and 6.30pm every weekday. GP appointments are available 8.30am to 11.30am and 4pm to 6pm every weekday. Extended hours appointments are offered from 6.30pm to 7.30pm on Monday to Thursday and on alternate Tuesday and Wednesday mornings from 7am to 8am.

Appointments can be booked over the telephone, on-line or in person at the surgery.

When the practice is closed, patients are advised, via the practice’s website that all calls will be directed to the out of hours service. Out of hours services are provided by Medvivo.

The practice has a General Medical Services contract to deliver health care services. This contract acts as the basis for arrangements between NHS England and providers of general medical services in England.

The practice provides services from the following sites:

The Old Orchard Surgery, South Street, Wilton, Salisbury, SP2 0JU
Cherry Orchard Surgery, Codford, St Mary, Warminster, Wiltshire, BA12 0PN
Spring Orchard Surgery, High Street, Fovant, Salisbury, Wiltshire, SP3 5JL
Till Orchard Surgery, High Street, Shrewton, Wiltshire, SP3 4BZ

Overall inspection

Good

Updated 19 May 2017

Letter from the Chief Inspector of General Practice

When we visited The Orchard Partnership, The Old Orchard Surgery on 28 September 2016 to carry out a comprehensive inspection, we found the practice was not compliant with the regulation relating to good governance. Overall the practice was rated as good.

We found the practice required improvement for the provision of well-led services because:

The practice governance systems, specifically the communication systems, did not always operate effectively or consistently.
The practice did not ensure that learning from complaints, significant events and alerts were adequately shared with all appropriate staff.

We also said the practice should:

Review the safeguarding policy to ensure it includes reference to the legal framework for safeguarding.
Ensure the practice’s comprehensive business continuity plan includes contact numbers for staff.
Ensure all staff receives an appraisal every 12 months.
Ensure they have adequate systems in place to ensure all emergency medicines are in date and suitable to use.

We undertook an announced focused inspection on 27 April 2017 to ensure the practice was meeting the regulation previously breached. For this reason we have only rated the location for the key question to which this relates. This report should be read in conjunction with the full report of our inspection on 31 August 2016, which can be found on our website at www.cqc.org.uk.

Our key findings were as follows:

The practice had implemented a new communication policy and procedure to ensure communications, including learning events, complaints and significant events were shared appropriately across their four sites.
The practice had revised their procedures to ensure learning was shared effectively across all sites.
The practice had updated its business continuity plan to include all staff contact numbers and their safeguarding policy to ensure it included reference to the legal framework for safeguarding.
The practice had revised their governance arrangements surrounding the management of emergency medicines to ensure they were all in date and suitable for use.
All staff had received an appraisal in the last 12 months.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice