Archived: Christmas Maltings Surgery Also known as The Christmas Maltings and Clements Practice

Updated 19 February 2015

Christmas Maltings and Clements Surgery, also known as Christmas Maltings and Clements Practice is located in Haverhill in Suffolk. The practice operates from The Christmas Maltings Surgery, Camps Road, Haverhill, Suffolk, CB9 8HF and Clements Surgery, Greenfields Way, Haverhill, Suffolk, CB9 8LU. There is also a branch surgery, Kedington Surgery, 36 School Road, Kedington, Suffolk, CB9 7NG. There is a dispensary at the Christmas Maltings Surgery.

The practice provides services for approximately 18,000 patients living in Haverhill and the surrounding villages. According to Public Health England information, the patient population has a slightly higher than average percentage of patients aged under 18 and slightly lower percentage of patients aged 85 or over, compared with practice average across England. Income deprivation affecting children and older people is significantly lower compared to the practice average across England.

The practice is a partnership of six GPs who hold financial and managerial responsibility for the practice. The practice employs six salaried GPs, seven registered nurses, including a nurse practitioner, an emergency care practitioner and three health care assistants. There is also a dispensary team, which includes a manager and senior dispenser. There is a practice manager and a team of non-clinical, administrative and reception staff who share a range of roles.

The practice is open between 8am and 6:30pm on weekdays. Pre-booked advance appointments could be made in person, by telephone or online. Patients who had an urgent need could telephone the practice and were advised of the sit and wait service at Clements Surgery. Patients could also turn up at Clements Surgery and if they needed to be seen on the day, the receptionist would ask them to sit and wait to see clinical staff. Early morning appointments for blood test appointments were also available.

Christmas Maltings and Clements Surgery does not provide an out-of-hours service to patients. Details of how to access emergency and non-emergency treatment and advice was available within the practice and on its website.

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

We inspected Christmas Maltings and Clements Surgery on 17 December 2014, as part of our new, comprehensive inspection programme.

The overall rating for this practice is good. We found the practice to be safe, effective, caring, responsive and well-led. The quality of care experienced by older people, by people with long term conditions and by families, children and young people is good. Working age people, those in vulnerable circumstances and people experiencing poor mental health also receive good quality care.

Our key findings were as follows:

• All of the patients we spoke with told us they were involved in decisions about their care and treatment and many complimented the quality of the clinical care they received.
• Faced with a national shortage of GPs, the practice had adopted alternative ways to meet patients' needs. This included employing a nurse practitioner and an emergency care practitioner.
• The practice had implemented new initiatives in order to respond to patient demand and the effectiveness of new processes was continually monitored.
• We found the practice was clean and patients we spoke with told us they had no concerns about cleanliness or hygiene at the practice. 

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• The practice recruitment policy should include the arrangements for undertaking criminal records checks using the Disclosure and Barring service for clinical and non clinical staff.
• Ensure that staff acting as chaperones understand their responsibilities when undertaking that role.
• Ensure that blank prescription forms are kept securely, so they cannot be accessed by unauthorised people.
• Ensure that information is available informing patients that they can ask to speak to the receptionist in private, if necessary.
• Ensure that the induction programme completed by new staff to the practice is documented.
• Consider whether there is scope to widen and further embed learning through improved record keeping around significant events.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 19 February 2015

The practice is rated as good for the population group of people with long term conditions. Emergency processes were in place that included a referral system so that patients in this group could receive timely care and support if they experienced a sudden deterioration in their health. When needed, longer appointments and home visits were available. All these patients had structured annual reviews to check their health and medication needs were being met. For patients with the most complex needs clinical staff worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 February 2015

The practice is rated as good for the population group of families, children and young people. Systems were in place for identifying and following-up children living in disadvantaged circumstances and who may be at risk of abuse. For example, children and young people who had a high number of A&E attendances or those with non accidental injuries. The practice were achieving acceptable immunisation rates for all standard childhood immunisations. We saw evidence that children and young people were treated in an age appropriate way and recognised as individuals. Patients we spoke with also confirmed this. Appointments were available outside of school hours and the premises were suitable for children and babies. We were provided with good examples of joint working with midwives, health visitors and school nurses. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health.

Updated 19 February 2015

The practice is rated as good for the care of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst 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. The practice was responsive to the needs of older people, including offering home visits, and rapid access appointments for those with enhanced needs.

Updated 19 February 2015

The practice is rated as good for the population group of  working age adults (including those recently retired and students). The needs of the working age population, those recently retired and students, had been identified. The practice was not currently offering extended hours appointments, due to prioritising clinical cover on weekdays, but these were due to recommence  in April 2015. The practice was proactive in offering online services and telephone consultations, as well as a full range of health promotion and screening which reflects the needs for this age group.

Updated 19 February 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. Dementia screening and memory clinics were provided at the practice. Patients with dementia were offered advance care planning.

The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations. The practice had a system in place to follow up on patients who had mental health needs who had not attended for their appointment and if there was concern.

Updated 19 February 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances. Longer appointments were offered to patients with most need, for example for those with a learning disability. A translation service was available for patients with limited understanding of the English language and longer appointments were provided to ensure adequate time was given when a translator was used.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector 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 and out of hours.