Market Lavington Surgery

Updated 31 May 2018

Market Lavington Surgery is a GP practice located in the village of Market Lavington near Devizes, Wiltshire. It is one of 47 practices within the Wiltshire Clinical Commissioning Group (CCG) area and has around 5,500 patients. The practice is one of five in the locality areas of Devizes.

The practice occupies a purpose built building with patient services located on the ground floor and first floors. There are seven consulting rooms and three treatment rooms. There are automatic front doors, a lift to the first floor, a self-check-in appointments system and a toilet with access for people with disabilities.

The practice is registered to provide the following activities:

• Diagnostic and screening procedures;
• Family planning;
• Maternity and midwifery services;
• Surgical procedures;
• Treatment of disease, disorder or injury.

The practice provides a number of services and clinics for its patients including childhood immunisations, family planning, minor surgery and a range of health lifestyle management and advice including asthma management, diabetes, heart disease and high blood pressure management.

The practice provides some services, such as a leg clinic in partnership with the other practices in the Devizes locality.

Data available shows a measure of deprivation in the local area recorded a score of 9, on a scale of 1-10, where a higher score indicates a less deprived area. (Note that the circumstances and lifestyles of the people living in an area affect its deprivation score. Not everyone living in a deprived area is deprived and not all deprived people live in deprived areas). The area the practice serves has relatively low numbers of patients from different cultural backgrounds. 97% of the practice population describes itself as white British. Average male and female life expectancy for patients at the practice is 80 years and 84 years respectively, which is the same as the Wiltshire average and in line with the national average of 79 and 83 years respectively.

There are four GP partners, two are male and two female. Some are part-time making a full-time equivalent of 2.6 GPs. They are supported by a nursing team of two practice nurses, a healthcare assistant and a clinical pharmacist. There is an administrative team led by the practice manager.

The practice is a training practice for medical students, trainee GPs and GP Physicians Assistants. At the time of our inspection there was a registrar being supported by the practice. (A registrar is a qualified doctor training to become a GP.)

The practice is open from 8am to 7pm, Monday, Tuesday and Thursday, 8am to 6.30pm on Wednesday and 7.30am to 6.30pm on Fridays. Appointments with GP’s are from 8.40am to 11.30am and from 3pm to 6pm, Monday to Friday. Extended hours appointments with a GP are available from 7.30am to 8am on Wednesday and Friday, and from 6.30pm to 8pm on Tuesday and Thursday.

The branch surgery at Urchfont had restricted opening times which were available from the practice and on their website. We did not visit the branch surgery as part of this inspection.

The practice has opted out of providing a full Out Of Hours service to its own patients. Patients can access an Out Of Hours GP service by calling NHS 111. Information about how to access this service was available in the surgery and on their website.

The practice has a General Medical Services contract with NHS England (a locally agreed contract negotiated between NHS England and the practice).

The practice provides services from the following sites:

• Market Lavington Surgery, The High Street, Market Lavington, Wiltshire, SN10 4AQ
• Urchfont Village Hall, Church Lane, Urchfont, Wiltshire, SN10 4QT

The practice has a website containing further information. It can be found here: www.marketlavingtonsurgery.nhs.uk

Updated 31 May 2018

This practice is rated as Good overall.

The key questions are rated as:

• Are services safe? – Good
• Are services effective? – Good
• Are services caring? – Good
• Are services responsive? – Good
• Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

• Older People – Good
• People with long-term conditions – Good
• Families, children and young people – Good
• Working age people (including those recently retired and students – Good
• People whose circumstances may make them vulnerable – Good
• People experiencing poor mental health (including people with dementia) - Good

We previously inspected the practice in November 2015 when we rated them good overall and for all the key questions, except for, “Are services safe”, which we rated as requires improvement. We carried out a focused follow-up inspection in March 2016 and rated them as Good for the provision of safe services.

The inspection of Market Lavington Surgery covered in this report was an announced comprehensive inspection on 1 May 2018. This inspection was carried out 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 learned from them and improved their processes.
• 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.
• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the previous 12 months. This was significantly above the national average of 84%.
• 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 provides some services, such as a leg clinic in partnership with the other practices in the Devizes locality.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

There are areas where the provider should make improvements. The provider should:

• Review processes for encouraging and supporting staff to raise significant events when appropriate.
• Review internal systems for assessing pain to ensure it meets recognised guidance.
• Review processes for recording consent to ensure these meet recognised guidance.
• Review new protocol for dealing with uncollected prescriptions to ensure it iseffective.

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

Updated 31 May 2018

Updated 31 May 2018

Updated 31 May 2018

Updated 31 May 2018

Updated 31 May 2018

Updated 31 May 2018