Old Fletton Surgery

Updated 12 November 2019

• Old Fletton Surgery is in the NHS Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) area.
• The practice is registered to provide diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
• There are approximately 12,500 patients registered at the practice. The practice dispenses medicines to those patients who live more than one mile from the nearest pharmacy. We visited the dispensary as part of this inspection.
• The practice is based on the ground floor and first floor of a building which was purpose built. The management clinical, reception and administration staff are based in different areas of the building.
• The practice has six GP partners and two other GPs. There are two nurse prescribers, four practice nurses and two health care assistants. The administration team consists of a practice manager and support staff. For the dispensary there is a pharmacist and dispensary staff.
• The practice is open between 8am and 6pm Monday to Friday. The dispensary is open between 8.30am and5.30pm Monday to Friday. Outside of practice opening hours, patients are directed to the local out of hours service provided by Herts Urgent Care through NHS 111. Extended hours are offered by the Greater Peterborough Network GP Hub.
• The practice serves patients living in a moderately deprived area of Peterborough. The overall deprivation decile is five, where one indicates areas with the most deprivation and ten indicates the least areas of deprivation. The practice demography is broadly similar to the CCG and England average.

Updated 12 November 2019

We had previously carried out an announced comprehensive inspection at Old Fletton Surgery on 25 September 2018. The overall rating for the practice was requires improvement; with requires improvement for safe, effective and well led services. Caring and responsive services were rated good. At this previous inspection, the practice was issued with a requirement notice for Regulation 17 (good governance). The full comprehensive report on that inspection can be found by selecting the ‘all reports’ link for Old Fletton surgery on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection, carried out on 4 September 2019, to check improvements identified at the previous inspection had been completed. At this inspection, we found that the practice had demonstrated improvements in most areas, however, they were required to make further improvements.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall and good for all population groups except families, children and young people which we have rated as requires improvement.

We found that

• The practice had taken appropriate action and responded to concerns we identified during our previous inspection.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patient’s care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice, legislation and technologies. This was monitored to ensure consistency of practice.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-center care.

At this inspection, we rated the practice as requires improvement for the population group of families, children and young people in the effective domain because:

• The practice had reflected on their public health England data and worked proactively to encourage uptake of childhood immunisations. However, at the time of the inspection, achievement in this area was below national targets.

Whilst we found no breaches of regulations, the provider should:

• Continue efforts to identify carers from the practice population to enable this group of patients to access the care and support they need.
• Take action to ensure that the monitoring of medicine fridge temperatures in the dispensary are managed inline with best practice guidelines.
• Review the approach taken in the identification of reporting concerns, safety incidents and near misses in both the practice and dispensary, to be assured that all staff were sufficiently aware of reporting thresholds as stated in the practice policy.
• Continue to monitor security risk assessments ensuring all areas are covered including access to the dispensary.
• Continue efforts to improve the uptake of child immunisations and the rates of cervical screening for eligible women across the practice population.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 12 November 2019

Updated 12 November 2019

Updated 12 November 2019

Updated 12 November 2019

Updated 12 November 2019

Updated 12 November 2019