Archived: West End Surgery

Updated 22 February 2017

The practice is known as West End Surgery. The practice is located in a purpose built premises. The practice has a patient population of approximately 7,486 registered patients. The practice population of registered patients aged between 0 to 4 is lower than the national average. The patients aged 65 years plus, 85 years and over are above higher that the national averages.

We were told that the profile of the population registered is changing with a significant number of new homes being built locally. The practice has applied for redevelopment financial support to cope with the increase in population locally, and rising registrations with the practice.

There is a car parking area with disabled bays but access for patients using prams and wheelchairs was difficult as there are no automatic doors. Reception staff do assist patients. There is a self-check in; reception has a low desk for wheelchair users and an accessible toilet. There is a dementia friendly sign, a hearing loop and a practice brochure in large print. There is a self-check blood pressure monitor available. A privacy screen is available in case of an emergency in a public area.

There are four GP partners, two female and two male, and a salaried GP. The practice employs three practice nurses and a health care assistant. There are two practice managers, two secretaries and nine receptionists. Services are provided via a General Medical Services (GMS) contract. (GMS contracts are negotiated nationally between GP representatives and the NHS)

The practice has core opening times between 8.00am to 6.30pm Monday to Friday. The practice offers GP and nurse telephone consultations, and phlebotomy appointments are available.

The practice has opted out of providing out of hours services to their patients. There are arrangements in place for services to be provided when the surgery is closed and these are displayed at the practice, in the practice information leaflet and on the patient website.

Services are provided from the following location:

West End Surgery

Moorgreen Road

Southampton

Hampshire

SO30 3PY

Updated 22 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West End Surgery on 23rd August 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Only 64% of patients said they could get through easily to the practice by phone compared to the national average of 73%.
• Some patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. Other patients told us the telephone lines were busy in the mornings.
• The practice had good facilities and was equipped to treat patients and meet their needs. However there were areas of health and safety that needed improvement such as the calibration of one type of equipment.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review systems and processes to ensure that all clinical equipment is calibrated regularly.
• To review the practice processes for identifying current smokers and giving advice on the benefits of stopping smoking
• Improve the access to the practice for making appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 February 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• We saw the call and recall systems in place to encourage patients to attend reviews. The practice had a manager responsible for the recall system.

• The Quality and Outcome Framework (QOF) clinical data for exception reporting for the practice, relating to Diabetes Mellitus (combined overall totals) is 13% compared to the CCG at 14% and a national average of 11%

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care, coordinated through the Integrated Care Teams.

• Two practice nurses had a lead for Long Term conditions, one for diabetes and the other for respiratory conditions.

Updated 22 February 2017

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 patients 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 patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years, the rates achieved for the practice were 81% in line with the CCG and national rate of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses, with meetings scheduled on a regular basis.

• There was an extra sit and wait clinic for young children.

Updated 22 February 2017

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice has developed an Integrated Care Team in conjunction with local practices, which offers a full assessment of patients with complex health and social care needs.

• The practice undertook admission avoidance reviews for vulnerable patients with long term conditions

• The GPs showed us documentation relating to patients residing in care homes had care plans.

• The practice worked closely with the local pharmacy and offered a variety of ways for patients to access prescribed medicines. We saw how prescription requests were handled on the day and the communication between the practice and the pharmacy.

• The practice worked closely with the local older peoples mental health services.

Updated 22 February 2017

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 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.

• There was a wide selection of self-help leaflets available in the waiting area.

• The practice had extended the hours of the phlebotomy (blood tests) service to enable patients who work to attend.

Updated 22 February 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• The practice chaired the multidisciplinary team meetings attended by partners, management and health and social care professionals.

Updated 22 February 2017

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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed 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.