Archived: Lantern Surgery

Updated 23 October 2017

Lantern Surgery offers primary medical services to the population of Esher and the surrounding area. There are approximately 5,800 registered patients. In 2015 the practice was taken over by The Groves Medical Centre who are a partnership of seven GPs, who also run three other practices in neighbouring areas.

Lantern Surgery is situated over two buildings, one for patients and one for administrative staff. Patients have access to a ground floor surgery with a small waiting area. All of the GP consulting rooms and treatment rooms are located on the ground floor. It is accessible to those patients with limited mobility, who use a wheelchair or for mothers with prams or buggies. There are patient facilities including a toilet for patients with disabilities. Staff offices are located in the building next door which cover the first and second floor.

The practice has within the last year increased their patient list from approximately 4,600 to nearly 5,800 and this has had an effect on the capacity of the practice to meet patient demands for appointments. As a result of this the practice is in the process of building two additional consultation rooms and an additional waiting area. They also plan to build offices on the ground floor for the administration team.

The practice team at Lantern Surgery is made up of a partner GP based at the practice (female), two salaried GPs (one male and one female), a nurse practitioner, two practice nurses and a healthcare assistant. The practice also has a team of receptionists, administrative staff and a branch manager. A further male salaried GP is due to start at the practice in October 2017.

The practice runs a number of services for its patients including asthma reviews, child immunisation, diabetes reviews, INR tests, (INR tests are used to check how well anticoagulant tablets such as warfarin and phenindione are working), and travel vaccines and advice.

Services are provided from:-

Lantern Surgery

3 Station Approach, Esher, Surrey, KT10 0SP

Opening Times

Monday to Friday 08:30am -12:30pm and 1:30pm - 6:30pm

Extended hours

Monday and Tuesday - 6:30pm - 7:30pm

Wednesday - 7am - 8am

During the times when the practice is closed, the practice has arrangements for patients to access care from Care UK which is an Out of Hours provider.

The practice population has a higher number of patients aged between birth and 14 years of age as well as over 85 years of age when compared to the national and local clinical commissioning group (CCG) average. The practice population shows a lower number of patients aged 15 to 29 years of age than the national and local CCG average. Less than 10% of patients do not have English as their first language.

Updated 23 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lantern Surgery on 27 September 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 was a partnership of seven GPs over four locations and the management and leadership structure was clear and available to staff. Staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• The practice had designed a booklet called ‘my health record’ for patients with cognitive problems. This recorded the patients medication, what it was for and the frequency it had to be taken. It also recorded all the people involved in the patients care and details of outcomes or care plans from GP appointments. The patient kept this booklet with them and could be used to help carers or family members understand the treatment and care the patient was receiving.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 October 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 23 October 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal and post-natal care.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 23 October 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• 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.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 23 October 2017

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

• The needs of these populations 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, extended opening hours.
• 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.
• Electronic Prescribing was available which enabled patients to order their medicine on line and to collect it from a pharmacy of their choice, which could be closer to their place of work if required.
• The practice offered NHS health-checks.
• Family planning and routine contraception services were available at various times of the day.
• The practice offered advice by telephone each day for those patients who had difficulty in attending the practice.

Updated 23 October 2017

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

• The practice carried out advance care planning for patients living with dementia.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 23 October 2017

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 those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.