Victor Street Surgery

Updated 7 September 2016

Victor Street Surgery is a training practice situated in Shirley, Southampton.

The practice has an NHS general medical services contract to provide healthcare and does this by providing health services to approximately 12,300 patients.

Appointments are available between 8.00am to 6.30pm from Monday to Friday. In addition early morning appointments are available between 7.30am and 8am on Monday, Tuesday, Thursday and Friday. Evening appointments are also available on Tuesday evenings between 6.30pm and 8.00pm and one Saturday per month between 8.30am and 11.30am. The practice has opted out of providing out-of-hours services to its patients and refers them to Care UK out-of-hours service via the 111 service.

The mix of patient’s gender (male/female) is almost half and half. The practice is located in an area of average deprivation. Victor Street Surgery treats a number of patients who have high intake of drug and alcohol and/or experience poor mental health.

The practice has nine GP partners and a GP registrar who together work an equivalent of eight full time staff. In total there are three male and seven female GPs. The practice also has four practice nurses and a phlebotomist and a health care assistant. The GPs and the nursing staff are supported by a team of 16 administration staff, the finance manager and practice manager.

Updated 7 September 2016

Letter from the Chief Inspector of General Practice

We carried out a focused inspection of Victor Street Surgery on 29 July 2016 to check that action had been taken since our previous inspection in April 2015. Overall the practice is rated as good. The practice was good for Effective, Caring, Responsive and Well Led services.

However we found that the practice required improvement in the Safe domain due to breaches of regulations relating to safe delivery of services.

We found that the practice had not ensured recruitment arrangements included all necessary employment checks for all staff. There were no fire and legionella risk assessments. Safeguarding, basic life support and fire safety training needed to be undertaken for relevant staff. The medicine/vaccination refrigerators required servicing and calibration. Prescriptions were not kept securely and only accessible to authorised people and the practice required effective infection prevention and control systems.

We inspected the practice on 29 July 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection of Victor Street Surgery on our website at www.cqc.org.uk

Our key findings for this inspection were as follows:

The provider had made improvements:

• Action plans had been produced following infection control audits.
• The practice reviewed its water safety risk assessment in relation to Legionella to ensure that the water supply did not pose a risk to patients, visitors or staff.
• Recruitment arrangements included all necessary employment checks for all staff had been carried out.
• Safeguarding, basic life support and fire safety training had been undertaken by relevant staff.
• New medicine/vaccine refrigerators had been purchased.

The practice is now rated good for Safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 August 2015

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

The practice held a number of nurse led clinics to support patients with long term conditions such as diabetes, coronary heart disease, asthma and chronic obstructive pulmonary disease. GPs supported patients with care plans that they regularly reviewed. Care plans also formed part of the practice’s hospital admissions avoidance. Complex Care meetings were held which reviewed hospital admissions and assessed whether admission could have been avoided and whether staff could have done anything differently. Notes of these meetings were made within patient notes as part of the review process. Minutes of the complex care meeting were taken and circulated to all GPs, district nurses, community nurses, over 75s nurse to ensure those not in attendance at the meeting were aware of discussions and subsequent actions.

Updated 27 August 2015

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 Accident and Emergency attendances. Appointments were available outside of school hours and the premises were suitable for children and babies. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly. Weekly family planning, antenatal and baby clinics were also available. We saw examples of joint working with midwives, health visitors and school nurses.

Updated 27 August 2015

The practice is rated as good for the care of older people.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services. For example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All of the patients over 75 had a named GP. Staff were able to recognise signs of abuse in older people and knew how to escalate or refer these concerns. The practice had a good working relationship with local community services and district nurses were based at the practice. Discussions took take place regularly between the district nurses and GPs. Monthly Multi-Disciplinary Team Meeting (complex care) were held which where attended by GPs, district nurses, community matrons and the over 75’s nurse.

Updated 27 August 2015

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. Access to GP advice was provided through telephone consultations as well as face to face appointments. There was an online booking system which enabled patients to book, change and cancel appointments and request repeat prescriptions without the need to visit or telephone the practice. NHS health checks were available for those aged between 40 and 74 and extended hours were available from 7.30am on four weekday mornings, until 8.00pm one weekday evening and one Saturday morning a month.

Updated 27 August 2015

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

The practice achieved good outcomes in relation to meeting the needs of patients with mental health needs. The practice kept a register of these patients which they used to ensure they received relevant checks and tests. Where appropriate, a comprehensive care plan had been completed for patients who were on the register. Care plans were written and agreed with patients and their carers. The practice hosted in house weekly counselling sessions and worked with multi-disciplinary teams to help meet the needs of patients experiencing poor mental health. For example, primary care mental health team counselling services.

Updated 27 August 2015

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. It offered annual health checks for patients with a learning disability and 70% of these patients had taken this up. It also offered longer appointments for patients with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Staff sign-posted vulnerable patients to various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff had undertaken training on domestic abuse and sexual violence and 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.