Archived: Fairstead Surgery

Updated 28 May 2015

Fairstead Surgery is owned by Vida Healthcare, a partnership made up of 20 partners who hold financial and managerial responsibility for six GP practices in Norfolk. At Fairstead Surgery there are four GP partners, nurses, a phlebotomist and a number of receptionists and administration staff. There is also a management team which includes a Chief Executive, a head of patient services, a head of people and governance, and a head of finance. There is a branch surgery which is located at St Augustine’s Surgery, Columbia Way, Kings Lynn, Norfolk.

Fairstead Surgery, in the West Norfolk Clinical Commissioning Group (CCG) area, provides a range of alternative primary medical services across two sites to approximately 5,600 registered patients living in Fairstead and the surrounding areas. According to Public Health England information, the patient population has a higher than average number of patients under 18 compared to the practice average across England. It has a slightly lower proportion of patients aged over 65, 75 and a slightly lower than average number of patients aged over 85 compared to the practice average across England. Income deprivation affecting children and older people was slightly higher than the practice average across England.

The provider had declared non-compliance with the Health and Social Care Act 2008 in April 2008 relating to the suitability of their premises. This was confirmed during the Commissions last inspection in February 2014. The practice premises were cramped and offered little potential room for improvement or expansion. We saw that where necessary the practice had risk assessed and put systems in place to safely manage risks. Following our inspection we were told approval for newly built premises had recently been given. The head of people and governance told us the practice were now developing a new business plan to secure newly built premises close to the current location. The practice was located close to a local hospital and an A&E department.

The practice provides a range of clinics and services, which are detailed in this report, and operates between the hours of 8am and 5.30pm, Monday to Friday with extended hours opening on Saturday mornings from 9am to 12 midday for pre-booked appointments. Appointments are available on the day, or pre-booked up to one month in advance. One GP provides an open surgery once a week for those patients who wish to wait and be seen by him. Outside of practice opening hours a service is provided by another health care provider by patients dialling the NHS 111 service.

Updated 28 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fairstead Surgery on 5 February 2015. The practice is led by the management team of Vida Healthcare who are the registered providers of Fairstead Surgery. There is a branch surgery located at St Augustine’s Surgery, Columbia Way, Kings Lynn, Norfolk.

Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive services and well led services. It was also good for providing services for 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 across all the areas we inspected were as follows:

• Patients told us they were treated with compassion, 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 Vida Healthcare 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.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should;

• Review storage and safety arrangements for all vaccines in the fridges.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 May 2015

The practice is rated as good for the population group of people with long term conditions. Staff had lead roles in chronic disease management and patients at risk of hospital admission were identified. All patients with long term conditions had structured reviews, at least annually, to check that 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 28 May 2015

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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health.

Updated 28 May 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. 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. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 28 May 2015

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 offered extended hours appointments on Saturday mornings and one GP provided an open surgery one day per week. 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 28 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice worked with other healthcare professionals including mental health crisis and counselling teams to support people experiencing poor mental health, including those with dementia. Patients with dementia were supported by the practice. They were given an annual review of their health and daily needs. There was liaison with the local dementia care services so that patients could be monitored in their own homes. Patients could be referred to the local drug and alcohol services to ensure they received appropriate support. The practice undertook meetings with local services and put systems and policies in place within the practice to identify those patients at risk of suicide or overdose attempts and provide rapid support and guidance.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia and were registered as Dementia Friends. Mental health counselling was available weekly. Longer appointments were available when necessary. Partnership working was taking place to support patients and their carers.

Updated 28 May 2015

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 homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and 70% of these patients had received a follow-up. 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, or had a learning disability. There were arrangements for supporting patients whose first language was not English.

The practice regularly worked with multi-disciplinary teams to support vulnerable people. It had told 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.