Southernhay House Surgery

Updated 13 December 2018

Southernhay House Surgery which is situated in the city centre of Exeter. The practice is comprised of two sites. The address of the main practice is 30 Barnfield Road, Exeter, Devon, EX1 1RX. The address of the branch is 10 Whipton Village Rd, Exeter, EX4 8AR.

We visited both sites during our inspection. The practice provides a service to approximately 8,200 patients of a diverse age group and offers the following regulated activities:

Treatment of disease, disorder or injury

Diagnostic and screening procedures

Maternity and midwifery services and

Surgical procedures

The deprivation decile rating for this area is five (with one being the most deprived and 10 being the least deprived). The practice is located in a deprived area of Exeter. The 2011 census data showed that majority of the local population identified themselves as being White British. The mix of male and female patients were equal. The average life expectancy for females was 83.5 years and 79 years for males (equal to national averages. The practice had 30% of its practice population over the age of 65 years compared to the national average of 27%.

There is a team of six GP partners (four male and two female). The GPs were supported by a full time GP registrar. The whole-time equivalent is 4.5GPs. The GP team were supported by a practice manager, a deputy practice manager, two practice nurses, one health care assistant, a phlebotomist and additional administration staff.

Patients using the practice also have access to health visitors, counsellors, carer support workers, district nurses and midwives who are co-located at the practice. Other health care professionals visited the practice on a regular basis.

The premises are open between 8am and 7.30pm and telephone lines between 8am and 6.30pm Monday to Thursday. On Friday the premises and telephones are open between 8am and 6.30pm. The practice is part of Exeter Primary Care (EPC), Federation of Exeter Practices which meant that practice patients could make routine appointments Monday to Friday between 6.30pm and 8pm and at weekends between 9am and 5pm at any Federation practice. The reception team informed patients which practice was on the rota for the varying extended hours and gave them a telephone number to call. Outside of these times patients are directed to contact the out of hour’s service and the NHS 111 number. This is in line with local contract arrangements.

The practice offers a range of appointment types including face to face same day appointments, telephone consultations and advance appointments (three months in advance) as well as online services such as access to records, online appointments and repeat prescription requests.

Updated 13 December 2018

This practice is rated as Good overall. (Previous rating July 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive at Southernhay House Surgery on 21 November 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice recognised where systems and processes had worked well and improved their processes where appropriate.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice offered a “yellow card” prescribing system for vulnerable patients who were unable to order prescriptions for themselves. A patient deemed suitable for the system had their medicines written up weekly/monthly on their clinical record. Their medicines were then written on a yellow card kept in reception. One of the yellow card administration team had a weekly task of generating prescriptions for these patients and sending them onwards to the relevant pharmacy.
• There was a strong focus on continuous learning, improvement and involvement at all levels of the organisation.
• Staff feedback was overwhelmingly positive. Staff acknowledged that the practice was a busy place to work but added that it was a good place to work and added that communication was effective.
• The practice was working to increase the numbers in its patient participation group to further engage with the patients.
• Governance arrangements were well established and effective at the practice. Online spreadsheets were used to monitor and alert staff to medicines and equipment expiry dates and trends occurring from surveys and other forms of feedback.

The areas where the provider should make improvements are:

• Review systems to monitor mental health and diabetes outcomes for patients.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Updated 13 December 2018

Updated 13 December 2018

Updated 13 December 2018

Updated 13 December 2018

Updated 13 December 2018

Updated 13 December 2018