Archived: Drs Sorensen-Pound and Thorpe Also known as Plowright Medical Centre

Updated 13 April 2017

Plowright Medical Centre provides primary care services to approximately 6,000 patients.

The surgery is located at 1, Jack Boddy Way, Swaffham, PE37 7HJ. The branch surgery at Necton, opened in 1995, and is located at North Pickenham Road, Necton PE37 8EF.

Swaffham is a market town situated approximately 12 miles east of Kings Lynn and 31 miles West of Norwich.

The practice has one senior partner (male) supported by four regular locum GPs, (one male and three female). There are four practice nurses, four health care assistance, twelve administrative staff, a practice manager and eight dispensary staff. Both sites have a dispensary. We inspected the main surgery dispensary at Swaffham. The practice dispenses to approximately 70% of patients at the main site and 100% of patients at the branch surgery.

The practice has opted out of providing GP out of hour’s services and this is provided by IC24 through the 111 non-emergency services.

Plowright Surgery Swaffham is open from Monday to Friday 8.30am – 6.30pm and closed from 1pm to 2pm on Tuesday. Necton Surgery is open from Monday to Friday 8.30am to 12 noon and 2pm to 5pm. The surgery closed at 12 noon on Thursdays.

The practice had a higher number of patients on their register aged 60 years and over compared to the national average, with over 1200 patients over the age of 70 (22%). Figures showed that 66% of patients had a long-standing health condition compared to the national average of 54%.

Updated 13 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Plowright Medical Centre on 12 January 2017. 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. We were able to evidence significant events were recorded and discussed at practice meetings.
• 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 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 upon.
• The provider was aware of and complied with the requirements of the duty of candour.
• Clinical and non-clinical audits were carried out.

• On the day of the inspection we found that prescriptions were not being logged when received or distributed.Subsequent to this the practice produced a standard operating procedure plus log sheets for recording blank prescriptions.

We saw an area of outstanding practice:

• The practice provided accommodation for two wellbeing counsellors and the service was available for all patients in the community.The practice provided and paid for the services of three additional counsellors for three sessions a week, with different areas of expertise including child adolescent and psychotherapy, mental health, hypnotherapy, cognitive behavioural therapy, eating disorders, post-traumatic stress, phobias and depression.Clinics slots were for one hour and a quiet room with settees had been made available to help make patients feel relaxed and comfortable.Referrals to these services were made by the GPs. The practice explained that there were no local services for children’s counselling and the wellbeing counselling service, although beneficial to some patients, had a long waiting time and intervention was limited to specific areas of treatment.They said that they felt it was important to provide a wider range of therapy sessions on a one to one basis for their patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 April 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 including asthma and diabetes.

Diabetic quality data from 2015/2016 showed:

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90mmHg or less was 97% which was 3% above the CCG average and 6% above the national average.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) 140/80 mmHg or less was 74% which was 7% below the CCG average and 4% below the national average.

Other services provided by the practice for this population group were:

• Longer appointments and home visits were available when needed.

• All 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. Bi-monthly multi-disciplinary meetings took place to discuss palliative care and reviews.

• The practice nurses had received specific training in diabetes; asthma and chronic obstructive pulmonary disease, to support the GPs’ manage long term condition patients.

• Home visits were available for patients whose condition made it difficult for them to attend the surgery.

• Same day appointments were offered if needed.

• The care home matron monitored patients in care homes and reported back to the senior partner if intervention was required.

Updated 13 April 2017

The practice is rated as good for the care of families, children and young people.

• Children were prioritised and fast tracked with regards to same day appointments.

• Free spoons and syringes were provided to patients in order to help administer medication.

• Appointments were staggered throughout the day making it easier for patients to book appointments for children before or after school.

• The practice had set up a social media website page to keep people up-to-date with changes or information about the services provided. Information included the introduction of a patient self-check in screen and a link to join the friends of Plowright medical centre Swaffham.

• Saturday flu clinics were available for patients unable to attend during the week.

• Patients aged 25-64, attending cervical screening within the target period of 3.5 or 5.5 years coverage was 82% compared to the CCG average of 84% and the national average of 82%.

• Travel vaccines were available, by appointment, during normal clinic times.

• Staggered appointments ensured that there were greater opportunities for appointments to be made outside of school hours premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses and the practice had introduced a safeguarding single point of contact.

• School readiness health checks were offered, at which additional support was offered for children preparing to start school, including communication, physical exercise and dental health.

• The practice had a dedicated children’s play area in the waiting room and baby changing facilities were available.

• The practice employed the services of a counsellor with specific skills in child psychotherapy and eating disorders.

Updated 13 April 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.

• A medicines delivery service was offered to vulnerable patients and those with long-term conditions and frailty who could not attend the surgery.

• Weekly or monthly dossett boxes were produced by the dispensary.(These are boxes containing medications organised into compartments by day and time in order to simplify the taking of medications).

• The practice nurse attended housebound patients to give flu vaccinations.

Updated 13 April 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 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.

• Telephone consultations were available for patients unable to attend the surgery.

• The practice had an internet social media page which gave useful health information and information on the services provided at the surgery.

Updated 13 April 2017

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

• Patients with dementia or poor mental health were telephoned prior to their appointment as a reminder that the appointment was due, and to check if the patient had any concerns or worries.

• 91% of patients diagnosed with mental health issues had a comprehensive care plan documented in their records in the preceding 12 months which was 7% below the CCG average and 2% below the national average. Exception reporting was 2.3% compared to the CCG and national average of 11%.

• 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.

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

• The practice provided accommodation for two wellbeing counsellors and the service was available for all patients in the community. The practice provided and paid for the services of three additional counsellors for three sessions a week, with different areas of expertise including child adolescent and psychotherapy, mental health, hypnotherapy, cognitive behavioural therapy, eating disorders, post-traumatic stress, phobias and depression. Clinics slots were for one hour and a quiet room with settees had been made available to help make patients feel relaxed and comfortable. Approximately 21 slots per week were available and referrals to these services were made by the GPs. The practice explained that there were no local services for children’s counselling and the wellbeing counselling service, although beneficial to some patients, had a long waiting time and intervention was limited to specific areas of treatment. They said that they felt it was important to provide a wider range of therapy sessions on a one to one basis for their patients.

Updated 13 April 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. Alerts on the practice medical system highlighted when immunisations were due for children.

• 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.