Washingborough Family Practice

Updated 4 January 2017

Washingborough Surgery provides primary medical services to approximately 6,886 patients in the village of Washingborough and surrounding areas in Lincolnshire including Branston, Heighington, Canwick, Potterhanworth and Nocton. The practice also provides services to patients residing in six nursing and residential homes in the surrounding area. The practice has a dispensary on site and dispenses medicines to approximately 10% of its patient population. The practice has a branch surgery located in the nearby village of Branston approximately three miles from the main practice which also has a small dispensary.

Following our inspection, we were informed by the practice of its decision to close both dispensaries to patients due to a significant decrease in dispensing patients. The practice informed NHS England of its decision and the remaining 443 patients of which the practice dispense to have been informed. The dispensaries will close in November 2016.

The practice is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning, maternity and midwifery services and surgical procedures.

At the time of our inspection, the practice employed 23 members of staff consisting of two GP partners, two salaried GPs and two GP registrars. A business manager, a practice manager, an assistant manager within reception, three practice nurses, one health care assistant, one phlebotomist, three dispensers and a team of reception, secretarial and administration staff.

The practice is a training practice and delivers training to GP Registrars. A GP Registrar is a fully qualified Doctor who is training to become a GP.

Washingborough Surgery is open from 8am until 6.30pm Monday to Friday with the exception of a Monday when the practice is open until 8pm. Appointments are available from 8.30am until 11am and from 3pm until 6pm Monday to Friday.

The practice has a General Medical Services (GMS) contract which is a contract between the GP partners and the CCG under delegated responsibilities from NHS England.

The practice has a higher population of patients between the ages of 40-79 years of age.

The practice has an active patient participation group (PPG) who meet on a regular basis.

The practice offers on-line services for patients including ordering repeat prescriptions, booking routine appointments and access to patient summary care records and detailed coded records.

Washingborough Surgery are part of a recently formed federation called ‘South Lincoln Healthcare Ltd’.

The practice has opted out of the requirement to provide GP consultation when the surgery is closed, the out-of-hours service is provided by Lincolnshire Community Health Services NHS Trust.

Updated 4 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Washingborough Surgery on 21 July 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. The practice had an effective risk register in place which included risk assessments in relation to the dispensaries.

• The practice had reviewed its processes for ensuring codes in use for vulnerable patients and those with either a safeguarding concern or suffered with a learning disability within the patient care record were continually reviewed and updated. The practice had worked closely with the local CCG to help to improve codes used to ensure other local practices were using the correct codes.

• 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.

• Performance for diabetes related indicators was 91% which was better than the national average of 89%. (Overall exception reporting rate was 6% which was better than the local average of 11%).

• 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.

• 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 practice arranged an annual social event for elderly patients held in the village of Washingborough which had been held for the past three years. All monies raised through this event were donated to a chosen charity.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure actions are taken to ensure the safe storage of Lloyd George patient records.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 January 2017

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 91% which was higher than the national average of 89%. (Overall exception reporting rate was 6% which was better than the local average of 11%).

• Longer appointments and home visits were available when needed.

• 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 4 January 2017

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 83%, which was higher than the CCG average of 78% and the national average of 74%.

• 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 4 January 2017

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.

• 68% of patients aged 60-69 years of age had been screened for bowel cancer within six months of invitation compared to the CCG average of 61% and the national average of 58%.

• The practice provided same day access to either an appointment, telephone consultation or home visit for older people who required this.

• Patients received personalised care plans from a named GP to support continuity of care.

Updated 4 January 2017

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 offered extended hours appointments until 8pm on a Monday evening each week with both GPs and nurses.

• 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.

• The practice offered a text reminder service for booked appointments.

• The practice provided an in-house physiotherapy service.

Updated 4 January 2017

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

• Performance for mental health related indicators was 99% which was higher than the national average of 93%. (Overall exception reporting rate was 21% which was higher than the local average of 15%).

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 4 January 2017

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 homeless people, 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.

• 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.