Sutterton Surgery

Updated 7 January 2016

Sutterton Surgery provides primary medical services to approximately 3,750 patients. They cover patients residing in Sutterton and the surrounding area including the villages of Algarkirk, Fosdyke and Wigtoft. The practice also covered areas up to the border of Boston, down to Pinchbeck and across to Holbeach.

The practice has a General Medical Services Contract (GMS). The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Sutterton Surgery is a single storey building. It has car parking facilities with spaces for patients with a disability. The practice has automatic doors at the entrance. They have two treatment rooms and two consulting rooms.

The practice provide dispensary services to 75% of patients.

At the time of our inspection the practice was run by a sole GP partner (male) and four long term locum GPs (two male and two female). The surgery also employed a practice manager, dispensary manager, two practice nurses, three dispensers and reception and administration staff.

The practice is located within the area covered by South Lincolnshire Clinical Commissioning Group (CCG). The CCG is responsible for commissioning services from the practice. A CCG is an organisation that brings together local GP’s and experienced health professionals to take on commissioning responsibilities for local health services.

South Lincolnshire Clinical Commissioning Group (CCG) comprises of 15 member GP practices. The CCG is split into two localities, Welland and South Holland. The CCG commission services for the populations of Stamford, Bourne, Market Deeping, Spalding, Long Sutton and surrounding areas. The main hospitals serving the population are Peterborough and Stamford Hospitals, Johnson Hospital, Spalding, Queen Elizabeth Hospital, Kings Lynn and Pilgrim Hospital, Boston.

South Lincolnshire has a much higher proportion of older people than the England average, and a lower proportion of young people. The prevalence of diabetes, coronary heart disease, stroke and cancer is higher in South Lincolnshire than for England as a whole.

We inspected the following location where regulated activities are provided:-

Sutterton Surgery, The Surgery, Spalding Road, Sutterton, Boston, Lincolnshire, PE20 2ET

The practice was open Monday to Friday 8.30am to 1pm, and 2.30pm to 6.30pm. The practice had phone in sessions for Urgent telephone advice from 8am to 8.15am and doctor led triage from 8.15am to 10am each day.

A variety of appointments to see a GP were available from 8.30am until 12.30 and 3pm until 5.30pm. In addition to pre-bookable appointments that could be booked up to four weeks in advance, urgent appointments were also available for people that needed them.

The practice offer minor surgical procedures on a Thursday evening. They also provide an on-site dispensing service for patient’s convenience.

In addition to pre-bookable appointments that could be booked up to four weeks in advance, urgent appointments were also available for people that needed them.

The practice had a website which we found had an easy layout for patients to use. It enabled patients to find out a wealth of information about the healthcare services provided by the practice.

Sutterton Surgery had opted out of providing out-of-hours services (OOH) to their own patients. The OOH service is provided by Lincolnshire Community Health Services NHS Trust.

Updated 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sutterton Surgery on 17 November 2015. 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.
• Most risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• 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.
• The practice had a number of policies and procedures to govern activity, but some were overdue a review.

The areas where the provider should make improvements:

• Improve the system for the identification of carers and vulnerable adults
• Consider the implementation of a training matrix to ensure that all staff receive training relevant to their role. For example, safeguarding training.
• Ensure all staff who act as chaperone have received appropriate training
• Further embed the system for the documentation for the recording of all refrigerator temperatures within the practice.
• Review and update procedures and guidance. For example, cold chain policy to provide staff with the guidance on the event of a potential failure.
• Embed a system to check NMC/GMC status for all relevant staff
• Ensure learning from complaints is disseminated to all staff.
• Embed a formalised process for the recording of minutes of meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 January 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.
• 88% of patients with diabetes had received an annual review. 91% of patients with COPD had received an annual review. 93% of patients with cardiovascular disease had received an annual review.
• 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 medicines 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 7 January 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.
• Childhood immunisation rates for the vaccinations given were above CCG/national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds and five year olds was 100%.
• 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. For example, the practice offered a sexual health and contraceptive service to patients registered with the practice.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice’s performance for the cervical screening programme was 77.8%, which was in line with the national average of 77.9%.
• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 7 January 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.
• Longer appointments and home visits were available for older people when needed, and this was acknowledged positively in feedback from patients.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• 85% of patients who had four medicines or more had received an annual review.2.3% of patients most at risk had a care plan in place.
• Flu vaccination rates for the over 65s were 69% which was slightly below the CCG average of 75.5% and national average of 72.99%. At risk groups 43.2% which was below the CCG average of 56.4% and national average of 53.23%.
• The practice offered a prescription delivery service.

Updated 7 January 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. For example, a daily morning triage service to enable patients to speak to a GP.
• 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.
• 92% of patients in this population group had had a blood pressure recorded in the last year.
• Health promotion advice was offered and there was accessible health promotion material available through the practice.

Updated 7 January 2016

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

• The practice had started to use the CANTAB mobile dementia tool to screen for dementia. This was brought in following information from the CCG that the dementia prevalence rates were low. Since using the tool the number of patients diagnosed with dementia has risen from 23 to 30 over the past six months.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 7 January 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.
• 93% of patients with a learning disability had had an annual review.
• It offered longer appointments for people with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• It had told 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.