The Wellspring Surgery, Dr Teed & Partners

Updated 3 September 2015

Wellspring Surgery is situated in St Anne’s which is one of the more deprived areas of the country. The percentage of adults and children affected by income deprivation is above the national average. The practice has a patient list of 9008 patients with a current annual list growth and turnover of 12% per year.

There are seven GP partners and one salaried GP working at the practice. This equates to 4.75 WTE. The practice had three male and four female GPs. The practice is a training practice and provides work placements for doctors in training (GP registrars) and medical students. GP registrars are qualified doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine. There is a team of two nurses and one healthcare assistant. There is both a practice manager and a deputy practice manager.

The Wellspring Surgery holds a Primary Medical Services Contract to provide primary medical services. This is a contract between NHS England and general practices for delivering general medical services. The practice has opted out of providing out of hours services, which is provided by Nottingham Emergency Medical Services.

Opening Hours are from Monday, Tuesday, Wednesday and Friday from 8.30am to 12.30pm and 1.30pm to 6.30pm. The practice closes on a Thursday afternoon at 1pm. The practice does not offer extended hours.

Updated 3 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Wellspring Surgery on June 2 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, safe, effective, caring and responsive services. It was good for providing services for the older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

• Staff knew how to report significant events and we found that action had been taken in response to safety alerts. Actions were taken following investigations in to significant events and we saw evidence that these were re assessed to consider the impact they had on patients. Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored appropriately, reviewed and addressed.
• The practice worked with other agencies to ensure the care and support provided to children and vulnerable adults was coordinated and effective.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff were aware of how to support patients whose capacity to understand and make decisions may be limited, for example for patients with dementia.
• 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. Complaints were dealt with appropriately and in a timely manner.
• There was a clear leadership structure and staff felt supported by the management. The practice proactively sought feedback from staff and patients, which it acted upon.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 September 2015

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

The practice had a high proportion of patients with long term conditions. Nursing staff and named GPs had lead roles in chronic disease management. The practice was achieving patient outcomes in respect of QOF which were above the CCG and National England Average in most areas. For example the practice was 1.8 percentage points above the CCG and 2.8 percentage points above the England average with regard to monitoring patients with asthma. QOF is a voluntary incentive scheme for GP practices in the UK. The scheme financially rewards practices for managing some of the most common long term conditions and for the implementation of preventative measures.

The practice had a system in place for the early identification of patients with diabetes. There was a high prevalence of patients with a diagnosis of diabetes in the practice. Longer appointments and home visits were available when needed. 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 3 September 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 circumstance who were at risk. The practice worked with and was responsive to partner agencies to ensure care was co-ordinated. Appointments were available outside of school hours and the premises were suitable for children and babies.

In line with the Healthy Child programme, the practice offered an eight week check for new babies. Staff were aware of the Gillick competencies which are used to help assess whether a child has the maturity to make their own decisions and to understand the implications of those decisions.

Childhood immunisation rates were lower than the CCG average in those children under the age of five years. The practice had been working with the CCG to try and find ways to improve these rates. However the practice was aware of factors such as a high number of patients who were only registered at the practice for a short period of time which could influence this uptake.

Updated 3 September 2015

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

Patients over the age of 75 years had a named GP, and there was a nominated GP for each of the three care homes in the practice area. The practice had identified the most vulnerable 2% of its older population and had care plans in place.

Home visits were available and the practice nurses visited care homes to provide flu vaccinations. The practice held multi-disciplinary meetings to ensure the care provided to older people was coordinated with other care providers. The practice maintained a register of frail older people which it regularly updated. The practice was purpose built with accessible rooms and lifts. The practice had introduced a falls prevention scheme to meet the needs of patients prone to falls.

Updated 3 September 2015

The practice is rated as good for the care of working-age people (including those recently retired and students.

Following feedback from a patient PPG survey, the practice had taken recent action to increase awareness of their online appointment booking system. The practice had a system to offer telephone consultations to improve access and offered flexible appointments to accommodate individual patient needs.

Updated 3 September 2015

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

Patients experiencing poor mental health were invited for annual health reviews. The practice worked with multi-disciplinary teams to support people experiencing poor mental health including those with dementia. The practice worked closely with  a specialist community psychiatric nurse and a psychiatrist who held regular weekly clinics at the practice to enhance the quality of patient care provided for these patients. Information about MIND which is a weekly support group for people experiencing mental health problems was available in the patient waiting room.

Updated 3 September 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

The practice held a register of patients who had a learning disability and offered annual health checks to this group of patients. At the time of our inspection 35 out of 50 patients had been invited to attend for an annual health check and all had been completed.

Staff were working to ensure  that all clients from this group had their health checks completed.

The practice has a high transient population and was responsive to the needs of those who were; asylum seekers, homeless and overseas immigrant

The practice used interpreter services for those patients whose first language was not English. It offered double appointments a number of patients whose circumstances may make them vulnerable to promote equitable patient care. Staff at the practice were aware of the arrangements in place to safeguard their patients, and how to respond to concerns. Information about how to access support services was available in the practice.