Shipdham Surgery

Updated 7 August 2019

Shipdham Surgery provides primary medical services to approximately 4,000 patients from its location in the village of Shipdham, Norfolk. The practice provides services under a General Medical Services contract from NHS South Norfolk Clinical Commissioning Group.

Shipdham surgery is in a semi-rural location with a higher than national average of patients aged over 65 and deprivation levels in line with local averages however, the practice was aware of their population having a mixture of more and less affluent patients.

The practice offers dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. We inspected the dispensary as part of this inspection.

The practice clinical team includes one female and two male GP partners, three female nurses and two female healthcare assistants.

The practice manager and dispensary manager lead the non-clinical team, including one dispenser, one receptionist and three staff who are trained in both dispensing and reception duties. A personal assistant worked across the site and the practice also had an apprentice working in an administrative role.

The practice is open between 8am and 6.30pm Monday to Friday but closed at lunchtimes. Patients calling when the practice is closed can speak to a GP for urgent matters. Between 6.30pm and 8am patients are directed to the local out of hours care provider through the NHS111 service or the local NHS Walk in centre.

The practice is registered with the care quality commission (CQC) to provide the regulated activities of; treatment of disease, disorder or injury, surgical procedures, diagnostic and screening procedures, maternity and midwifery services and family planning.

Updated 7 August 2019

We carried out an announced focussed inspection at Shipdham Surgery on 18 July 2019 to follow up on breaches of regulations identified at a previous inspection in November 2018.

At the last inspection we rated the practice as requires improvement for providing safe services because:

• The practice was not always assured that locum staff had appropriate training and safety checks to carry out their role safely and checks carried out were not always documented.
• The stock of emergency medicines kept in the practice was not in line with guidelines and the practice had not assessed the risks of not having these medicines.
• Access to the dispensary was not restricted, and the arrangements for managing standard operating procedures and monitoring compliance was not always effective.

We also identified areas the practice could improve at our last inspection including:

• Monitor and improve the time patients wait beyond their appointment time.
• Review the system for identifying and providing support to carers.
• Complete structured annual reviews for patients with learning disabilities in a timely manner.

At this inspection we rated the practice as good for providing safe services because sufficient improvements had been made since our last inspection:

• The practice had collected appropriate recruitment and training records for existing long-term locums and put in place a recruitment checklist for new locum staff.
• The practice stock of emergency medicines had been risk assessed and updated to include relevant medicines in line with guidelines.
• The practice had reviewed security arrangements in the dispensary and had brought forward scheduled security upgrades. Dispensary access restrictions were improved to include non-dispensary staff not entering the dispensary, using messaging services for questions and queries and challenging any unauthorised access. Arrangements also included scheduling cleaning to occur when the dispensary was open and supervised. Standard operating procedures (SOP) were reviewed and updated and all dispensary staff signed individual SOPs with compliance monitored through governance meetings and monitoring of near misses and incidents.
• The practice had identified where patients were waiting longer than expected beyond their appointment time. Average wait times were monitored and improved from 8.7 minutes between arrival and being seen to 6.5 minutes.
• The practice had introduced better identification and read coding of carers onto the clinical computer system including through new patient registration forms. The practice provided carers information packs, offered annual flu vaccines and signposted carers to additional support. The numbers of carers in the practice was 54 (Approximately 1.3% of the practice population).
• The practice had appointed a lead clinician to oversee health checks for patients with learning disabilities, including attending the local residential homes to ensure these patients had access to health checks. At the time of inspection, the practice had 28 patients registered and had completed 16 annual health checks with 12 scheduled for completion.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 18 December 2018

Updated 18 December 2018

Updated 18 December 2018

Updated 18 December 2018

Updated 18 December 2018

Updated 18 December 2018