Stanton Surgery

Updated 24 August 2016

Stanton Surgery is a purpose built practice situated in Stanton, Suffolk. The practice provides services for approximately 4,900 patients. It holds a General Medical Services contract with West Suffolk CCG.

According to information taken from Public Health England, the practice has a higher than average number of patients aged over 60. However, there is a lower than average number of patients aged between 20 and 44. The practice is in an area with a low level of deprivation.

The practice team consists of one male GP, three female GPs, a practice manager, two practice nurses, a health care assistant and a phlebotomist. It also has teams of reception, administration, secretarial and dispensary staff.

Stanton Surgery is open from Monday to Friday. It offers appointments between 8 am and 6.30 pm daily, with extended hours appointments available between 6.30 pm and 7 pm on Mondays and Wednesdays, and from 7.30 am to 8 am on Tuesdays, Thursdays and Fridays. The practice also has a branch surgery in the neighbouring village of Hopton. It offers nursing appointments from 8 am to 6.30 pm on Mondays, 8 am to 1 pm on Tuesdays,Wednesdays and Thursdays and 8 am to 4.30 pm on Fridays. Hopton Surgery was not inspected as part of this inspection. Out of hours care is provided by IC24 via the NHS 111 service.

Updated 24 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stanton Surgery on 16 June 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, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care inline with current evidence based guidance. Staff had been trained to provide them with the skills,knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care was consistently positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in January 2016 showed that patients rated the practice higher than others for several aspects of care.
• 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.
• 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 were often able to pre-book appointments within 24 hours of patient request, alongside on the day appointments.
• 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 well 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 one area of outstanding practice:

• The practice team was forward thinking and part of local pilot schemes to improve outcomes for patients in the area, such as monthly shared practice nurse and diabetic specialist nurse clinics for patients with diabetes who had complex needs. This had been well received by patients and staff, who felt that it offered good learning opportunities alongside enhanced patient care.

The areas where the provider should make improvement are:

• Ensure that staff appraisals are undertaken in a timely manner.
• Continue to review and update procedures and guidance.
• Undertake regular fire drills.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 August 2016

long-term conditions.

• Both GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2014/2015 showed that performance for diabetes related indicators was 100%, which was above the CCG average of 92% and the national average of 89%. Exception reporting for diabetes related indicators was 12%, which was in line with the CCG average of 12% and the national average of 11% (exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).
• Longer appointments and home visits were available when needed.
• Patients with complex needs had a named GP and a structured annual review to check their health and medicines needs were being met. There was a robust recall system in place to ensure that patients were invited and attended annual reviews.
• 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 24 August 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 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.
• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 89%, which was above the CCG average of 81% and national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered a full range of contraception services and chlamydia screening.
• We saw positive examples of joint working with midwives,health visitors and school nurses.

Updated 24 August 2016

The practice is rated as good for the care of 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 triaged all home visit requests to facilitate earlier visits where hospital admission may be an outcome.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people,including rheumatoid arthritis and heart failure, were above local and national averages.

Updated 24 August 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.
• Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years.
• Extended hours appointments were available between 6.30 pm and 7 pm on Mondays and Wednesdays, and from 7.30 am to 8 am on Tuesdays, Thursdays and Fridays.

Updated 24 August 2016

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

• 76% of patients diagnosed with dementia had received a face to face care review in the last 12 months, which was below the CCG average of 82% and the national average of 84%.
• 95% of patients experiencing poor mental health had a comprehensive care plan, which was above the CCG average and national averages of 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 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.
• 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 24 August 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 other health care professionals in the case management of vulnerable patients, and held six weekly multidisciplinary team meetings.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Patients who were carers were proactively identified and signposted to local carers’ groups. The practice engaged with West Suffolk Family Carers, a local charity who regularly attended the practice and identified carers who needed extra support.
• 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.