West Coker Surgery

Background to this inspection

Updated 20 November 2017

Dr Lindsay Smith is an individual provider on the outskirts of Yeovil. Dr Smith supported around 1,800 patients and operated as one of two practices based in the shared Westlake Surgery premises. On 1 October 2016 the other individual provider in the premises, retired and Dr Smith was commission by Somerset Clinical Commissioning Group to take on responsibility for those patients. The practice is now known as West Coker Surgery and supports approximately 3,800 patients. There is a dispensary on site that was shared by both practices and is now operated by Dr Smith. The practice was able to provide pharmaceutical services to those patients on the practice list that lived more than one mile (1.6km) from their nearest pharmacy premises.

This report relates to Regulated Activities provided from:

West Coker Surgery

High Street

West Coker

Yeovil

Somerset

BA22 9AH.

The practice has a General Medical Services (GMS) contract to deliver health care services; the contract includes enhanced services such as childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for patients with dementia and minor surgery services. An influenza and pneumococcal immunisations enhanced service is also provided. These contracts act as the basis for arrangements between the NHS Commissioning Board and providers of general medical services in England.

The general Index of Multiple Deprivation (IMD) population profile for the geographic area of the practice is in the third least deprivation decile. (An area itself is not deprived: it is the circumstances and lifestyles of the people living there that affect its deprivation score. It is important to remember that not everyone living in a deprived area is deprived and that not all deprived people live in deprived areas).

The age distribution of male and female patients similar to national average figures. Average life expectancy for the area is higher than national figures with males living to an average age of 83 years and females to 85 years.

There is one male GP partner who provides eight sessions per week as well as various locums who provide a total of six sessions per week. The GP is supported by a practice nurse, two part-time healthcare assistants, a practice manager and additional administrative staff. The dispensary has a team of four dispensers, including a dispensary manager.

Patients using the practice also have access to community staff including district nurses and health visitors. A midwife is based at the practice one half day session per week. The practice is a level two research practice and carries out studies to identify potential improvements to patient care.

The practice is open from Monday to Friday, between the hours of 8.30am and 6.30pm, with extended opening hours from 6.30pm to 7.30pm every Tuesday and Thursday. GP appointments are 12 minutes long and typically are available from 8:30am to 11.30am and from 5pm to 6pm each Monday, Wednesday and Friday; and from 3.45pm to 6.30pm each Tuesday and Thursday. GPs offer patients face to face appointments, telephone consultations, and make home visits where appropriate.

When the practice is closed patients are directed to the NHS 111 service where patients can be referred to Vocare GP Out of Hours service if further clinical advice is required.

Overall inspection

Good

Updated 20 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Coker Surgery (then known as Westlake Surgery) on 23 November 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for West Coker Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 1November 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice and all population groups are now rated as good.

Our key findings were as follows:

Staff had a record of appropriate training relevant to their role, including up to date training in safeguarding adults, basic life support, fire safety and infection control.
There were effective arrangements in place to assess, monitor, manage and mitigate risks in respect of health and safety. These arrangements included systems for addressing Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts, reviewing patients’ medicines, the risk assessment of legionella; and a comprehensive business continuity plan was in place.
Arrangements for engaging patients with a learning disability and those diagnosed with a mental health condition were in place which ensured they had the appropriate care and support and attended annual reviews.
Systems were in place to assess, monitor and improve the quality and safety of the service, including those for up to date record keeping, including for staff training and for significant events; for a rolling programme quality improvement, such as clinical audits; and for engaging with patients, such as through a patient participation group.
Arrangements to identify and support carers were in place.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice