Archived: Dr. S.J. Godfrey & Partners

Updated 1 February 2017

Dr SJ Godfrey and partners, is located at Totton Health Centre, Totton, Hampshire, SO40 3ZN. Totton is town on the outskirts of the city of Southampton. The practice provides services under a NHS Personal Medical Services contract and is part of the NHS West Hampshire Clinical Commissioning Group (CCG).

The practice has approximately 11,600 registered patients. The practice population has marginally above average number of patients over 50 years old and marginally less than average number of the under 40 age group when compared to the national average. The practice population is predominantly White British. The practice is located in an area of low deprivation in comparison to national average for England. The building is owned by NHS estates and managed via a separate management company.

There are eight partners at the practice, seven are GP partners and one is a business partner. Of the seven GP partners four are male and three are female. One GP partner had recently left at the time of inspection but is returning to the practice as a salaried GP from October 2016. This equates to approximately five full time GPs. The practice is a training practice for doctors (registrars) training to become a GP. At the time of the inspection there was one GP registrar working at the practice. The GP partners are supported by a nursing team consisting of three nurse practitioners, a lead practice nurse, three senior practice nurses, a practice nurse and two health care assistants as well as a phlebotomist. This equates to approximately five full time members of nursing staff. In addition to clinical staff the practice has a team of administrative staff which includes secretaries, a business partner, reception/administration staff and patient service manager/deputy manager.

The practice reception and phone lines are open between 8.30am and 6.30pm Monday to Friday. The practice opens its doors from 8.20am. Extended hours appointments are offered on a pre-bookable basis from 6.30pm to 8pm every Monday and Tuesday as well as every third Saturday morning between 8am and 12pm. The last available appointment to pre-book on a Monday or Tuesday is 7.20pm. Telephone consultations are available from 7.30pm to 8pm during extended opening hours. On Wednesday to Friday the last available appointment is 5.10pm followed by telephone consultations. The duty doctor will cover until 6.30pm.

In addition to pre-bookable appointments, patients can have a same day appointment with the duty team which consists of a GP and the nurse practitioners. Patients can pre book same day or next day appointments as well as those for up to two weeks in advance. Telephone consultations and home visits are also available. The practice can see up to 100 on the day patients during a busy day. The practice offers online facilities for booking of appointments and for requesting repeat prescriptions.

Dr SJ Godfrey and Partners has opted out of providing out-of-hours services to their own patients and patients are requested to contact the out of hours GP via the NHS 111 service. Information about this is displayed in the reception area and on the practices website.

Updated 1 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr SJ Godfrey and Partners on 19 July 2016. Overall the practice is rated as good. Our key findings across all the areas we inspected were as follows:

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Reviews and investigation had taken place when needed. We found learning was not consistently recorded as being shared with relevant members of staff. At the time of the inspection learning points had been noted, but there were no details of ongoing monitoring of actions taken to maintain patient safety.

• Risks to patients were assessed and managed. There was an open and transparent approach safety and systems in place for reporting and recording significant events. However at the time of inspection the documentation was not always clear regarding the cascade to staff.

• 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. However not all action was taken as to whether the patient was satisfied with the response received , best practice suggests that efforts are made to ensure a complainant is fully satisfied with the response to their concerns.

• Following the inspection the provider informed us of changes they had made to their systems to ensure information was cascaded to relevant staff.  

• Data showed patient outcomes were comparable to the national average. We saw evidence that audits were driving improvements to patient outcomes.

• Information about services was available; patients who wished to have information leaflets in their own language could request this from the administration staff.

• 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.

• 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.

• The practice had a number of policies and procedures to govern activity. However there was not a clear version control and several versions of the same policy were available to staff. Other policies had in some cases overlapping information. The practice were in the process of uploading all current policies onto their computer system.

• 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 must make improvements are:

• Review recording arrangements of staff training to demonstrate that safeguarding adults training has been delivered.
• Continue to review arrangements to ensure that learning points and actions from significant are consistently documented and shared with all staff and actions are monitored.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 1 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.
• The percentage of patients with diabetes who had a foot examination and risk classification within the past 12 months was 92% which is comparable to the clinical commissioning group average of 90% and national average of 88%.
• 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.

Updated 1 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 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.

• The percentage of eligible women at the practice who had a record of having a cervical screening test within the past five years was 95% which was above the clinical commissioning group average of 82% and national average of 82%.

• Appointments were available outside of school hours.

• The practice did not have any dedicated baby changing facilities, but the practice was able to make suitable arrangements when needed.

• The practice promoted a local support group for mothers experiencing mental health problems during pregnancy and after childbirth.

• The practice had information leaflets on display promoting a support service available for young adults aged 14-18.

Updated 1 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.
• Patients on the palliative care list were discussed at virtual ward meetings and partner meetings.
• The practice had links to a care navigator who would put elderly patients in contact with various support groups and contact carers on a yearly basis. The care navigator contacted all patients over 75 that had been discharged from hospital.

Updated 1 February 2017

The practice is rated as good for the care of working age people

• 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.
• Extended hours appointments were available on Monday and Tuesday evenings as well as some Saturdays mornings.
• 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.

• Patients could book appointments via the telephone, by attending the practice or using the online system.

Updated 1 February 2017

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

• 88% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder or other psychoses whose alcohol consumption had been recorded in the past 12 months was 93% which is comparable to the clinical commissioning group average of 88% and national average of 90%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living 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 those living with dementia.

Updated 1 February 2017

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

• The practice held a register of patients living in vulnerable circumstances including homeless patients, travellers and those with a learning disability. The practice identified 72 patients on their learning disabilities register. All these patients were offered annual reviews with the GP and nurse.

• 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 children. Records examined did not demonstrate that training had been given to staff on safeguarding vulnerable adults. 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.