Great Witley Surgery

Updated 2 April 2019

Great Witley Surgery is a village ten miles north west of Worcester City. The practice has a branch surgery in Martley. There is a dispensary at both sites for practice patients who live over one mile (1.6km) from the surgery. As part of the inspection we visited both sites.

The practice primarily covers a rural area for patients in the surrounding villages which covers approximately 120 square miles. The main surgery is in purpose built premises which is adjacent to the village hall.

The provider is registered with CQC to deliver the Regulated Activities: diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

Great Witley Surgery is situated within the South Worcestershire Clinical Commissioning Group (CCG) and provides services to 6801 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

Parking is available on-site and a chaperone service is available for patients who request the service. This is advertised throughout the practice.

The practice has four GP partners (two male and two female) and two salaried GPs (both female), a clinical pharmacist, three practice nurses, one health care assistant and one phlebotomist. The clinical team is supported by a practice manager and a team of administrative, reception and dispensary staff.

The practice is a training practice and regularly hosts trainee GPs.

There are higher than average number of patients between the ages of 45-64. The National General Practice Profile states that 98% of the practice population is from a white background with a further 2% of the population originating from black, Asian, mixed or other non-white ethnic groups. Information published by Public Health England rates the level of deprivation within the practice population group as eight, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice is open between 8am and 6.30pm Monday to Friday. Home visits are available for patients who are too ill to attend the practice for appointments.

The practice does not provide out of hours services to their own patients. When the practice is closed patients are directed to contact Care UK via NHS 111.

The practice website can be viewed at: www.greatwitleysurgery.nhs.uk

Updated 2 April 2019

We carried out an announced comprehensive inspection at Great Witley Surgery on 14 February 2019 as part of our inspection programme.

At the last inspection in January 2016 we rated the practice as good overall with outstanding for proving responsive services.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected

• information from our ongoing monitoring of data about services and

• information from the provider, patients, the public and other organisations.

We have rated this practice as outstanding overall.

We rated the practice as outstanding for providing responsive services because::

• The practice had taken an active role to engage with the rural community in aspects of social prescribing since 2017. It had secured funding for a social prescribing project and to reach out to services in the local community to create a directory to enhance residents’ health and wellbeing. They initiated a social prescribing event in October 2018 which was attended by 40 local services. The day included an afternoon tea and jazz event which was attended by over 80 residents. The day brought community services together and enabled services such as Age UK to sign up six new volunteers, as well as the fire service carry out six home assessments. Following this the practice presented the rural aspects of social prescribing at The Midlands Social Prescribing Network Conference in January 2019. During the past twelve months the practice had seen an 11% reduction in its hospital admissions during 2018, which the practice attributed to the positive effect that social prescribing initiatives had on patients’ general well-being.

• The National GP Patient Survey Results for 2017 and 2018 were significantly higher than local and national averages in outcomes relating to access. The practice had achieved the second highest GP Patient Survey results in Worcestershire for the past two years and voted in the top ten nationally during 2017. Comment cards and patients who we spoke with on the day of inspection were overwhelmingly positive about the flexibility the practice offered its patients in responding to their needs.

• The practice continued to offer its annual Christmas lunch to the older population and vulnerable patients. It was now in its fourth year and had been expanded to all members in the local community. The event was provided in the adjacent village hall and entertainment and a Christmas gift was provided to those who attended. Numbers had continued to grow and had been attended by over 60 in 2018. The practice had received feedback from patients on the benefits this event had to their overall wellbeing.

We have rated the practice as outstanding for providing caring services because:

• Patient satisfaction through the National GP Patient Survey was higher than both the CCG and England averages across all indicators relating to caring.
• Patient feedback through comment cards, reviews on NHS Choices and patient consultations on the day of the inspection were very positive about the caring nature of the practice.
• The practice demonstrated an understanding and commitment to valuing, respecting and showing compassion to their patients. The practice could evidence that they went the extra mile to ensure patients dignity was respected and they were committed to their patients care.
• The practice had identified and supported 103 carers which represented 1.5% of the practice list size. In addition, the practice kept a register of 45 patients who were unofficial carers to ensure they were aware of support and information to support them.

We also rated the practice as good for providing, safe, effective and well-led services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.

• Patients received effective care and treatment that met their needs.

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

• The practice worked proactively with other organisations to ensure patients had access to a range of services to support their health and wellbeing.

• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.

• The practice worked proactively with the Patient Participation Group (PPG) to undertake a number of surveys and respond to patients’ needs.

• The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.

Whilst we found no breaches of regulations, the provider should:

• Complete a risk assessment for the security of keys in the dispensary.

• Continue to review antibiotic prescribing to check that it is in line with best practice.

• Record minutes of meetings in a timely manner.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 2 April 2019

Updated 2 April 2019

Updated 2 April 2019

Updated 2 April 2019

Updated 2 April 2019

Updated 2 April 2019