Archived: The Chesterfield Drive Practice

Updated 3 March 2016

The Chesterfield Drive Surgery is situated in Ipswich, Suffolk. The practice has a branch surgery in Landseer Road in Ipswich. The practice provides services for approximately 14700 patients. The practice holds a Personal Medical Services (PMS) contract.

According to Public Health England information, the patient population has a higher number of patients aged 0 to 19 compared to the practice average across England. It has slightly lower proportions of patients aged 35 to 39 and 45 to 59 compared to the average across England. The number of female patients over 85 years of age is above average. Other age groups are in line with the practice average across England. Income deprivation affecting children is in line with the practice average across England, income deprivation affecting older people is slightly below the practice average across England and the overall deprivation across the practice population is slightly above the practice average across England.

The practice has four GP partners, three male and one female and three salaried GPs. One of the partners is retiring in September 2016. There are four nurse practitioners (of which one is still in training), one clinical practitioner, four practice nurses, three health care assistants and one phlebotomist. The practice also employs a practice manager, office manager and an office team consisting of 18 personnel in varying roles to support the practice.

The practice offers on site physiotherapy, minor surgery and mental health link worker clinics; midwives hold clinics weekly at both locations.

The practice is a training practice with one active registrar GP and hosts medical students. The practice also partakes in research with the Primary Care Research Network.

There is a pharmacy housed in the same premises but this operates as a separate entity.

The practice’s opening times at the time of the inspection were from 08:00 to 18.30 Monday to Friday at both locations. Extended opening hours were from 18:30 to 20:00 on Wednesday at the Chesterfield Drive location and on Saturday the practice operated extended hours between 08:00 and 11:00, three weekends out of four at the Chesterfield Drive location, and one weekend out of four at the Landseer Road location.

Appointments with clinicians could be booked twelve weeks in advance. During out-of-hours appointments were available with GP+ (an Ipswich GP based out-of-hours provider) between 18:30 and 21:00 on weekdays and between 09:00 and 21:00 during weekends. During the remaining out-of-hours times GP services were provided by CareUK.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chesterfield Drive Surgery on 21 January 2016. 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, and addressed. Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.

We saw one area of outstanding practice:

• One of the GPs worked as a MacMillan GP for the area and as such shared in depth knowledge of cancer care. The practice treated all new patients with cancer diagnoses as significant events.

The areas where the provider should make improvement are:

• Ensure that the practice’s computer system indicates links to the next of kin of children that are deemed vulnerable.
• Improve ease of access to policies and procedures for staff.
• Ensure annual reviews for learning disability, mental health and dementia patients are undertaken in a timely way.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

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

• Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• One of the GPs was a MacMillan GP for the area; as a result the practice undertook thorough reviews of patients with a new cancer diagnosis.
• Quality Outcome Framework performance for a variety of long term conditions was equal or better compared to the CCG and national average.
• Longer appointments and home visits were available when needed.
• Long term condition clinics were held during which care plans could be modified in light of discussion with the patient.

Updated 3 March 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.
• 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 practice had a comprehensive cervical screening programme. The practice’s percentage of patients receiving the intervention according to 2014-2015 data was 93.4%, which was above the England average of 81.8%. Patients who didn’t attend their appointment were followed up with letters and via the telephone.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives and health visitors.
• Childhood immunisation rates for the vaccinations given to under twos ranged from 91.1% to 96.9% compared to the local average of 94.8% to 97.7%,and for five year olds from 94.3% to 99.6% compared to the local average of 92.6% to 97.2%.
• A family planning clinic was held weekly, during which a GP and three other clinicians could fit contraceptive coils and implants.

Updated 3 March 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.
• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.
• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs.
• The practice worked with multi-disciplinary teams when providing care for older people, if required.
• There was a programme of visits to local care homes.

Updated 3 March 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.
• Extended hours appointments were available one evening during the week and on Saturdays.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 3 March 2016

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

• 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 112 registered patients with dementia of which 50 had received an annual review since April 2015. 50 of 145 patients with mental health problems had a care review recorded since April 2015.
• The practice carried out advance care planning for patients with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. A mental health link worker visited the practice regularly.
• 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.

Updated 3 March 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.
• The practice offered longer appointments for patients requiring this.
• The practice carried out annual health checks for people with a learning disability and 65 out of 119 of these patients had received a review since April 2015.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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 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. However, the records for children with safeguarding concerns were not always linked with their next of kin.