Cobbs Garden Surgery

Updated 25 April 2016

Cobbs Garden Surgery provides a range of primary medical services, including minor surgical procedures from its location at West Street, Olney in Buckinghamshire. The practice serves a population of approximately 8,450 patients with higher than average populations of both males and females aged 10 to 14 years and 40 to 74 years. There are lower than average populations 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 two female GP partners, three male GP partners, a lead nurse, three practice nurses, a specialist nurse for the elderly 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 training practice.

The practice is supported by a local charity, the Friends of Cobbs Garden Surgery, who organise various fundraising initiatives and manage donations made from patients and local businesses. The practice utilises donations to develop its service provision for patients, including the employment of a female counsellor for patients experiencing poor mental health.

The practice is open between 8am and 8.30pm on Monday and between 8am and 6.30pm Tuesday to Friday. Extended hours are also available on Saturdays between 9am and 11.15am. Patients requiring a GP outside of normal hours are advised to phone the NHS 111 service.

Updated 25 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cobbs Garden Surgery on 22 March 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 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.
• 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.
• 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.

We saw an area of outstanding practice:

• The practice benefitted from donations made to a local charity, the Friends of Cobbs Garden Surgery. This provided substantive funds, enabling the practice to improve outcomes for patients. For example, employing a specialist nurse for the elderly and a counsellor for patients experiencing poor mental health.

However there was one area where the provider should make improvement:

• Ensure that recently adopted procedures for managing blank prescriptions are monitored and sustained.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 April 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.
• 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 98% compared to a national average of 94%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and were invited to a structured annual review to check their health and medicine needs were being met. For those patients with more complex needs, the named GP worked with relevant health care professionals to deliver a multi-disciplinary package of care.

Updated 25 April 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 may be 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.
• The percentage of patients diagnosed with asthma, on the register, who had received an asthma review in the last 12 months was 95% compared to a national average of 75%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 84%, which was comparable to the CCG average of 74% and the national average of 82%.
• 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, health visitors and school nurses.

Updated 25 April 2016

The practice is rated as outstanding 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 used funds received from a local charity, the Friends of Cobbs Garden Surgery to benefit and improve outcomes for patients in this population group, for example by employing a specialist nurse for the elderly.
• The specialist nurse for the elderly provided holistic care and tailored support for these patients.
• The flu vaccination rate for the over 65s was 75% which was comparable to the national average of 73%.

Updated 25 April 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.
• Evening appointments were offered until 8pm on Mondays and appointments were available every Saturday between 9am and 11.15am.
• The practice was proactive in offering online services, such as appointment booking, as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 25 April 2016

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

• 88% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice employed a counsellor to support patients referred by GPs. This service was funded by charitable donations and free to patients.
• 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 patients with mental health needs and dementia.

Updated 25 April 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 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 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.