Greensands Medical Practice

Updated 17 June 2016

Greensands Medical Practice provides a range of primary medical services, including minor surgical procedures from its semi-rural location at Brook End, Potton, Sandy in Bedfordshire. The practice has a branch surgery, known as the Gamlingay Surgery on Stocks Lane, Gamlingay in Cambridgeshire. There is a dispensary at both the main practice and the branch surgery that provides medicine for patients who live more than one mile from a pharmacy.

The practice serves a population of approximately 11,700 patients with higher than average populations of both males and females aged 40 to 74 years. There are lower than average populations of babies and patients aged 15 to 39 years. The practice population is largely white British. National data indicates the area served is less deprived in comparison to England as a whole.

The clinical staff team consists of three female GP partners, four male GP partners, one nurse prescriber, one minor illness nurse, two practice nurses and two health care assistants. The team is supported by a practice manager and a team of administrative staff. The practice holds a General Medical Services (GMS) contract for providing services and is a teaching practice, receiving medical students from the Cambridge University Medical School.

Greensands Medical Practice is open between 8.30am and 12.30pm Mondays to Fridays, and from 2pm to 6.30pm on Mondays, Tuesdays, Wednesdays and Fridays. The practice is closed on Thursday afternoons. A GP is available from 8am Mondays to Fridays. The branch surgery in Gamlingay is open from 8.30am to 12.30pm Mondays to Fridays, and from 2pm to 6.30pm on Mondays, Tuesdays, Thursdays and Fridays. The branch surgery is closed on Wednesday afternoons. Patients requiring a GP outside of normal hours are advised to phone the NHS 111 service.

Updated 17 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Greensands Medical Practice on 3 May 2016. 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had introduced a GP telephone triage system and nurse led minor illness clinics to improve appointment availability.
• Patients 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.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Develop a centralised system for recording actions taken as a result of safety alerts.
• Continue to develop and adopt procedures for managing blank prescriptions.
• Carry out fire drills on a regular basis.
• Develop systems to ensure policies and procedures are routinely reviewed and updated.
• Continue to identify and support carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 June 2016

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

• Nursing staff supported GPs in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was similar to the national average. For example, the percentage of patients on the diabetes register, who had received an influenza immunisation in the preceding 12 months was 99% compared to a CCG average of 95% and a national average of 94%.
• Longer appointments and home visits were available when needed.
• The practice ran an anticoagulant clinic for patients to monitor their treatment. (Anticoagulants are medicines used to prevent blood from clotting).
• All these patients had a named GP and 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 17 June 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. Immunisation rates were relatively high 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.
• The practice’s uptake for the cervical screening programme was 79%, which was comparable to the CCG average of 76% and the national average of 74%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• A consultant gynaecologist provided a monthly in house clinic.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 17 June 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice carried out memory assessments for patients at risk of dementia.
• Annual health checks were available for these patients.
• All these patients had a named GP.

Updated 17 June 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.
• 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.
• Telephone consultations were available for those unable to attend the surgery during normal working hours.
• A nurse led telephone results line operated daily to feedback patients’ test results, for example following blood tests or X-rays.

Updated 17 June 2016

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

• There was a lead GP for mental health.
• Performance for mental health related indicators was similar to the national average. For example, the percentage of patients with diagnosed psychoses who had a comprehensive agreed care plan was 91% where the CCG average was 87% and the national average was 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out memory assessments for patients at risk of dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 17 June 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 travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.
• 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.