• Doctor
  • GP practice

St Luke's Surgery

Overall: Good

Warren Road, Guildford, Surrey, GU1 3JH (01483) 510030

Provided and run by:
St Luke's Surgery

Latest inspection summary

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Background to this inspection

Updated 13 June 2016

St. Luke’s Surgery is a practice offering general medical services to the population of Guildford, Surrey. There are approximately 10,600 registered patients.

The practice population has a higher number of patients between 25-49 years of age and 85+ years of age than the national average. The practice population also shows a lower number of patients between the age of 15-24 and 55-69 year olds than the national average. There are a slightly lower number of patients with a longstanding health condition. The percentage of registered patients suffering deprivation (affecting both adults and children) is lower than both the CCG and national average.

St. Luke’s Surgery is run by six partner GPs (three male and three female). The practice is also supported by a salaried GP; three female practice nurses, two healthcare assistants, a team of administrative / reception staff, an assistant practice manager and a practice manager.

The practice runs a number of services for patients including asthma clinics, diabetes clinics, coronary heart disease clinics, minor surgery, child immunisation clinics, new patient checks and holiday vaccinations and advice.

Services are provided from one location:

St. Luke’s Surgery, Warren Road, Guildford, Surrey, GU1 3JH. The practice is part of NHS Guildford and Waverley CCG.

Opening hours are Monday to Friday 8am to 6:30pm.

During the times when the practice is closed arrangements are in place for patients to access care by calling NHS 111. The out of hours care provider is Care UK.

Overall inspection

Good

Updated 13 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St. Luke’s Surgery on 23 March 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.
  • Risks to patients were assessed and well managed, including those relating to recruitment checks.
  • Feedback from patients about their care was consistently and strongly positive.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them 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.
  • 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.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice implemented suggestions for improvements and made changes to the way they delivered services as a result of feedback from patients.
  • 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:

  • The practice should review the complaints process to ensure patients are given information on how they can escalate the complaint if they remain dissatisfied.

  • Review the opening times in line with patient feedback in respect of access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 13 June 2016

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.
  • Data from 2014/15 showed the percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) is 5 mmol/l or less was 93% compared to the national average of 81%.
  • Two GPs and the lead practice nurse all hold the Warwick certificate in diabetes care (The Certificate in Diabetes Care (CIDC) course is the UK's leading foundation course in diabetes care).
  • Patients diagnosed with diabetes had access to a podiatrist every quarter to enable high quality foot care and there was a diabetes care clinic every two weeks.
  • 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.

Families, children and young people

Good

Updated 13 June 2016

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.
  • Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
  • 82% of eligible patients had received cervical screening which was the same as the national average.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • There was a youth counsellor available at the practice for children and young adults.
  • We saw positive examples of joint working with midwives and health visitors.
  • The practice ensured that children needing emergency appointments were seen on the day.

Older people

Good

Updated 13 June 2016

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 people in its population.
  • The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
  • The practice supported a number of patients in local care homes and ran regular weekly rounds to meet their needs.
  • The practice had identified elderly patients that were the most vulnerable and created advanced care plans which were patient held but also available for ambulance staff to view via a computerised system.
  • The practice contacted all patients that had been discharged from hospital within three days to discuss their care needs.

Working age people (including those recently retired and students)

Good

Updated 13 June 2016

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.
  • Telephone appointments were available for patients who could not attend the practice due to work commitments or where they could not attend the surgery.
  • The practice offered text reminders for appointments to prevent patients not attending.
  • Electronic prescribing was available which removed the need for working people to attend the surgery to collect their prescriptions.

People experiencing poor mental health (including people with dementia)

Good

Updated 13 June 2016

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

  • 90% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average of 84%.
  • Data from 2014/15 showed that the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 86% which was comparable to the national average of 88%.
  • The practice assisted patients in accessing the Surrey Independent Living Council funding to enable breaks for carers.
  • 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 developed a carer’s pack which contained information regarding the help available.
  • The practice was part of the Improving Access to Psychological Therapies (IAPT) programme which enabled patients to access support for conditions such as stress and depression.
  • 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.

People whose circumstances may make them vulnerable

Good

Updated 13 June 2016

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 homeless people, travellers and 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.
  • The practice was the sole GP care provider for patients living at a refuge where women, often with young children, were placed after fleeing domestic violence.
  • The practice had a lead GP for patients diagnosed with learning disabilities and co-ordinated care with the local learning disability specialist nurse and team.
  • The practice provided medical services for two local homes which catered for people with learning difficulties. The GPs conducted annual health checks for these residents.