The Village Surgery

Updated 15 November 2016

The Village Surgery is part of the NHS Stockport Clinical Commissioning Group (CCG). Services are provided under a general medical services (GMS) contract with NHS England. The practice has about 5400 patients on their register.

Information published by Public Health England rates the level of deprivation within the practice population group as 10 on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The average male and female life expectancy in the locality is 84 years (men) and 86 (women) which is higher than both the CCG and England averages of 79 and 83 years respectively.

The practice building is a converted Victorian property that provides consultation rooms over three floors. A passenger elevator is available to assist patients with mobility issues or parents with baby pushchairs. Other adaptations to the building had been made to ensure people with disabilities could access them. There is an onsite car park.

The practice is a registered partnership between two female and one male GP. The practice employs a practice manager, two practice nurses and one health care assistant as well as reception and admin staff. The practice is a GP training practice.

The practice reception is open from 8.00am until 6.30pm Monday to Friday. Later evening appointments with a GP, a practice nurse and a health care assistant are available until 7.30pm on Wednesdays and until 8.30pm on Thursdays.

When the practice is closed patients are asked to contact NHS 111 for Out of Hours GP care.

The practice provides online access that allows patients to book and cancel appointments and order prescriptions.

Updated 15 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Village Surgery on 19 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, although a policy and procedure was not available.
• Risks to patients were assessed and well managed.
• 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 were enthusiastic in their praise of the practice. They 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 usually found it easy to get through to the practice on the telephone and could get an appointment with a named GP. The GPs provided a telephone appointment service which patients said they liked.
• The GPs provided a telephone triage service for urgent appointments and responded to patients’ telephone messages in line with recently implemented criteria.
• 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 had awareness of where it wanted to improve its services and had plans to develop them to meet future challenges.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Develop a procedure for the reporting and responding to significant events to support the activity already in place .
• Develop a policy and protocol for responding to medical emergencies to support the staff’s knowledge already in place.
• Provide the practice team with clinical protocols to support their roles and responsibilities.
• Continue to actively promote, develop and facilitate a patient participation group to provide feedback about the service provided by the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 November 2016

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

• GP partners had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice’s performance was above the average of the Clinical Commissioning Group (CCG) and the England average in some of the diabetes indicators outlined in the Quality and Outcomes Framework (QOF) for 2014/15.
• The practice encouraged patients to self refer to education programmes such as Expert for the management of diabetes and other long-term conditions.
• 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 15 November 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 comparable to the Clinical Commissioning Group (CCG) rates 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.
• Appointments were available outside of school hours and the premises were adapted to support parents with young children and babies.
• Quality and Outcome Framework (QOF) 2014/15 data showed that 79% of patients with asthma on the register had an asthma review in the preceding 12 months compared to the CCG average of 76% and the England average of 75%.
• The practice’s uptake for the cervical screening programme was 88%, which was better than the CCG and the national average of 82%.
• We heard about positive examples of joint working with midwives, health visitors and school nurses.

Updated 15 November 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.
• Planned weekly visits to two local care homes were undertaken by the GPs. This provided continuity of care.
• Monthly multi-disciplinary team meetings were held in the local neighbourhood to review specific patients considered at high risk of hospital admission.
• The practice was proactive in supporting patients on the palliative care register and used the electronic communication tool Electronic Palliative Care Coordination Systems (EPaCCS) to record information that was accessible to the Out of Hours provider and the local hospital.

Updated 15 November 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 offered flexible surgery times including later evening appointments until 7.30pm on Wednesdays and 8.30pm on Thursdays. Appointments were available with a GP, a practice nurse and health care assistants on these later appointments. Pre-bookable telephone consultations were also available.
• The practice was proactive in offering online services such as booking and cancelling appointments and ordering prescriptions.
• The practice website also offered information on health promotion and screening.

Updated 15 November 2016

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

• Data from 2014/15 showed that 94% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was higher than the Clinical Commissioning Group (CCG) average of 87% and the England average of 84%.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the preceding 12 months, which was higher than the CCG average of 91% and the England average of 88%. However, the practice’s clinical exception reporting rate was also higher at 40% compared to the CCG average of 9% and the England average of 13%. The practice explained this was a coding error on the patients’ electronic record system.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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.

Updated 15 November 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 those with a learning disability.
• The practice offered longer appointments for patients who were vulnerable and those 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.