Archived: The Devonshire Practice

Updated 16 April 2018

The Devonshire Practice provides services under a personal medical services (PMS) contract to approximately 5,762 patients.

The practice is registered to provide regulated activities which include:

Treatment of disease, disorder or injury, surgical, family planning, maternity and midwifery services and Diagnostic and screening procedures and operate from the location;

The Devonshire Practice

262 Devonshire Ave,

Portsmouth,

Southsea

PO4 9EH

www.thedevonshirepractice.co.uk

The practice population is in the sixth least deprived decile for deprivation. In a score of one to ten the lower the decile the more deprived an area is. The average life expectancy is lower than the national average.

Updated 16 April 2018

This practice is rated as Good overall. (Previous inspection January 2015 – Good)

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 carried out an announced comprehensive inspection at The Devonshire Practice on 22 February 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 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.

• 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.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• Patients with a learning disability or whose first language was not English were automatically booked an extended appointment time.

• The practice used the Electronic Frailty Index (EFI) for patients over 65 years to help identify and predict risks for older patients in primary care. Patients identified as living with severe frailty were also reviewed every month at multi-disciplinary meetings in order to co-ordinate care to meet individual needs.

• The practice offered same day appointments and a ‘sit and wait’ service for patients who did not have an appointment.

• The practice used a text message system to remind patients of appointments.

The areas where the provider should make improvements are:

• Review the clinical auditing and quality improvements processes to evidence positive outcomes for patients.

• Review thetelephone access to increase patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 July 2015

The practice is rated as good for the population group of people with long term conditions. The practice was aware of those patients with long term conditions and had processes in place to make urgent referrals to secondary care should it be necessary or when longer appointments or home visits were needed. All these patients were offered structured annual reviews to check their health and medication needs were being met. Patients were involved in developing their care plan. Flu vaccinations for patients within the at-risk groups were higher than the national average. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 16 July 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. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice held weekly antenatal clinics and baby clinics. All the GPs provided antenatal care and family planning services. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 16 July 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. Regular meetings were held with integrated care and multi-disciplinary care teams. Patients receiving end of life care and support also had care plans which were shared using the special notes system with out of hours providers. Flu vaccinations for over 65 years were higher than the national average. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. Those patients aged over 75 who had not been seen in the practice in the previous 12 months could request a consultation and were assigned a named GP.

Updated 16 July 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 and flexible. The practice offered online services which enabled patients to book appointments or request prescriptions. There was a full range of health promotion information and screening offered that reflected the needs for this age group. NHS health checks were offered to all patients under the public health scheme and those patients between the ages of 16 and 75 who had not been seen at the practice for more than three years could request a health check. Pre bookable appointments were available until 8 pm two evenings each week for patients who could not attend during normal working hours.

Updated 16 July 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). The practice population included a number of military veterans (ex-service personnel) who may be at additional risk. The electronic system highlighted to staff and GPs those patients who were veterans.

When appropriate patients experiencing poor mental health were signposted to other support organisations. Patients were referred by their GP to a local counselling service and staff were also trained to direct patients to the service directly if necessary, or advise patients how to make a self-referral to this service.

The dementia diagnosis rate for this practice was higher than the national average.

Updated 16 July 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice was aware of those patients living in vulnerable circumstances and those with a learning disability. They were aware of the needs of this group of patients and ensured they had access to appointments at times which suited them. GPs and staff were aware of the added needs of their patients with a learning disability and the support these patients required to access GP appointments. Some of these patients were on the practice’s admission avoidance scheme. However registered patients with a learning disability who do not have an annual health assessment by the practice should be supported to have access to medical reviews.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Vulnerable patients were advised of 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 and documentation of safeguarding concerns. Staff had received training in safeguarding at a level appropriate to their role.