Archived: New Westborough Surgery

Updated 17 December 2015

New Westborough Surgery is located in a predominantly residential area in Westcliff on Sea, Essex. The practice provides services for 3300 patients and covers a catchment from the edge of Milton Ward to north of the London Road and part of Prittlewell.

The practice holds a General Medical Services (GMS) contract and provides GP services commissioned by NHS England and Southend Clinical Commissioning Group. A GMS contract is one between GPs and NHS England and the practice where elements of the contract such as opening times are standardised.

The practice is operates from purpose built premises, which they shared with two other GP practices.

The practice population is similar to the national average for younger people and children under four years, and for those of working age and those recently retired, and for older people aged over 75 years. Economic deprivation levels affecting children, older people are slightly higher than the practice average across England. Life expectancy for men and women are similar to the national averages. The practice patient list compares similarly to the national average for long standing health conditions and disability allowance claimants. The practice patient population compares to the national averages for working aged people in employment or full time education and those of working age that are unemployed.

The practice is registered to an individual GP who holds financial and managerial responsibility. However at the time of our inspection The GP had entered into a partnership with a second GP who has worked at the practice for a number of years in a salaried position. In addition to the two male GPs the practice also employs two female locum GPs who work on a part time basis and two practice nurses. The practice did not have a practice manager at the time of our inspection. The day to day management arrangements were overseen by a member of the administrative team who was supported by a team of two administrative staff and three receptionists.

The practice is open between 8am and 6pm on weekdays. GP and nurse appointments are available between 8.50am and 11.10 am, and 3.50pm to 6pm with extended opening times and appointments available up to 8pm each Monday evening.

The practice has opted out of providing GP out of hour’s services. Unscheduled out-of-hours care is provided by the NHS 111 service and patients who contact the surgery outside of opening hours are provided with information on how to contact the service.

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Westborough Surgery on 25 November 2015. Overall the practice is rated as good.

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

• 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. Learning from when things went wrong was shared with clinical staff but not widely shared within the practice. People affected by safety incidents were offered an explanation and an apology.

• Risks to patients were assessed and well managed. There were systems for assessing risks including risks associated with medicines, premises, equipment and infection control.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Clinical audits and reviews were carried out to make improvements to patient care and treatment.

• Staff told us that they had received training appropriate to their roles. Staff files did not always include details of training undertaken. There was a system for staff appraisal. However files we looked at did not include records of staff appraisal.
• 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 investigated and responded to appropriately and apologies given to patients when things went wrong or their experienced poor care or services.
• Patients said they found it easy to make an appointment with a named GP and that 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.
• 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure that learning from significant events and other safety incidents are widely shared across the practice.

• Maintain records in respect of checks undertaken including checks on medicines and emergency equipment.

• Ensure that staff personnel files are reviewed and include documents that reflect training and appraisals undertaken.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

The practice is rated as good for the care of people with long-term conditions. GPs and nursing staff had lead roles in chronic disease management and provided a range of clinics including asthma, diabetes and chronic obstructive pulmonary disease (COPD). The practice performance for the management of these long term conditions was similar to or higher than other GP practices nationally.

Patients at risk of unplanned hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. 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 17 December 2015

The practice is rated as good for the care of families, children and young people. The practice offered same day appointments for children. Appointments were available outside of school hours. Post-natal and baby checks were available to monitor the development of babies and the health of new mothers.

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 similar to other GP practices 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.

Information and a range of sexual health and family planning clinics were available.

Updated 17 December 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people, and offered home visits and rapid access appointments for those with enhanced needs.

Weekly GP visits were carried out to a local care home to review patients and monitor changes to their healthcare needs.

GPs worked with local multidisciplinary teams to reduce the number of unplanned hospital admissions for at risk patients including those with dementia and those receiving end of life palliative care.

Updated 17 December 2015

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 offered evening appointments up to 8pm on Mondays for working aged people who may find it difficult to access the practice during normal working hours.

The practice was proactive in offering online services including on-line appointment booking and electronic prescribing (where patients can arrange for their repeat prescriptions to be collected at a pharmacy of their choice).

The practice offered a full range of health promotion and screening that reflected the needs for this age group including well man and well woman checks.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice reviewed and monitored patients with dementia and carried out face-to-face reviews.

Patients with mental health conditions were reviewed and had an annual assessment of their physical health needs. Longer appointments and home visits were provided as required. The practice supported patients who lived at a local hostel and provided same day appointments when required.

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

It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 17 December 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Staff undertook safeguarding training and the practice had a dedicated safeguarding lead.

The practice held a register of patients living in vulnerable circumstances including patients with a terminal illness and those with a learning disability. The practice proactively promoted annual health checks for patients with learning disabilities and carried out home visits for these reviews as needed.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. This helped to ensure that patients whose circumstances made them vulnerable were supported holistically and that patients who were at a higher risk of unplanned hospital admissions were supported to and treated in their home.

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.