The New Surgery

Updated 5 December 2016

The New Surgery is located in Mexborough on the outskirts of Doncaster. The practice provide services for 6,941 patients under the terms of the NHS General Medical Services contract. The practice catchment area is classed as within the group of the second most deprived areas in England. The age profile of the practice population is similar to other GP practices in the area. 

The practice has three GP partners, two female and one male. They are supported by a GP, two GP locums,  two advanced nurse practitioners, two practice nurses, a healthcare assistant, a phlebotomist, a practice manager and a team of reception and administrative staff. 

The practice is open between 8.30am to 6.30pm on weekdays with late evening appointments with the practice nurse and healthcare assistant until 8pm on Monday and from 7am on Thursday. Appointments with all staff are available during the practice opening hours. A phlebotomy service with the healthcare assistant is available daily. In addition to pre-bookable appointments that could be booked up to six weeks in advance for GP appointments and 12 weeks in advance for practice nurse appointments, urgent appointments were also available for people that needed them. 

When the practice is closed calls were answered by the out-of-hours service which is accessed via the surgery telephone number or by calling the NHS 111 service. 

The practice is located in a purpose built building with consultation and treatment rooms on the ground floor.  There is accessible car parking to the front of the building.

Updated 5 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The New Surgery on 17 October 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 with the exception of prescription security.

• 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.
• 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.
• Some patients said they found it difficult to get through to the practice by telephone however, there was continuity of care, with urgent appointments available the same day.
• The practice 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 upon.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are: 

• Review the incident reporting process to include review of relevant policy or procedure during the investigation process.
• Review the prescription security procedures to track them through the practice in order to comply with NHS Protect Security of prescription forms guidance (Updated August 2013).
• Revisit the contract of the premises with the landlord to include a service level agreement to determine who is responsible for the maintenance and upkeep of the premises, utilities and fixtures and fittings.
• Implement a procedure to capture actions taken by the practice in response to best practice guidance and medicine alerts.
• Review the layout of the layout of the waiting area to promote confidentiality and also access to two treatment rooms via pharmacy floor space.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 5 December 2016

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

• Nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was 4% above the CCG average and 11% above the national average.
• 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 5 December 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 accident and emergency 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 80%, which was below the CCG and national average of 82%.
• 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 5 December 2016

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.

Updated 5 December 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.

Updated 5 December 2016

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

• 89% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.
• Of those experiencing poor mental health 85% had an agreed care plan in place which was lower than the national average of 88% 
• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice carried out advance care planning for patients living 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 those living with dementia.

Updated 5 December 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 homeless people 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.