Oldfield Surgery

Updated 22 March 2023

Oldfield Surgery is located at:

45 Upper Oldfield Park,

Bath,

BA2 3HT.

The practice has two branch surgeries at:

St James’s Surgery

6-9 Northampton Buildings,

Bath,

BA1 2SR.

Junction Road Surgery

8 Junction Road,

Oldfield Park,

Bath,

BA2 3NQ. (This surgery was closed at the time of inspection).

The provider, Heart of Bath, is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury, family planning and surgical procedures. These are delivered from all sites.

The surgery offers services from both a main practice and two branch surgeries. Patients can access services at either the surgery or St James’s Surgery branch. Junction Road Surgery was temporarily closed at the time of inspection.

The surgery is situated within the Bath and North East Somerset Swindon and Wiltshire Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 28,000. This is part of a contract held with NHS England.

The Heart of Bath is a Primary Care Network (PCN) in its own right with no other member practices.

Information published by UK Health & Security Agency shows that deprivation within the practice population group is rated in the second highes decile (nine of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 3.7% Asian, 94.2% White and 2.1% Mixed.

There is a team of five GP Partners and 11 salaried GPs who provide cover at both locations. The practice has a team of advanced nurse practitioners and nurses who provide clinics for long-term conditions and support acute management services of use of both locations. As well as a paramedic to support home visiting services. The clinical team are supported at the practice by administration staff comprising of patient service advisors and business support administrators. The practice manager and human resources (HR) manager are based at the main location to provide managerial oversight.

Oldfield Surgery is open between 8am to 6pm Monday, Wednesday and Friday and 7.30am to 6pm Tuesday and Thursday. St James’s Surgery is open between 8am to 6pm Monday to Friday. The practice offers a range of appointment types including ‘book on the day’, telephone consultations, advanced routine appointments and home visiting from both locations.

Extended access is provided by the Oldfield Surgery, where Saturday morning appointments are available from 8am to 12pm. The provider has opted out of providing out of hours services and this is provided by NHS 111, available through Medvivo.

Updated 22 March 2023

We carried out an announced focused inspection at Oldfield Surgery on 26 August 2022. Overall, the practice is rated as Requires Improvement.

Safe - Requires Improvement

Effective - Requires Improvement

Well-led - Requires Improvement

Following our previous inspection on 27 July 2021, the practice was rated Requires Improvement overall and for all key questions but Good for providing caring and responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Oldfield Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a focused inspection to follow up on the breach of regulation 17: Good Governance, found in July 2021.

The ratings for Caring and Responsive were carried forward from the previous inspection. Both are rated Good.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• The practice provided care that did not always keep patients safe. In particular, high-risk medicine monitoring and appropriately actioning safety alerts.
• Patients did not always receive effective care and treatment that met their needs. In particular, outstanding monitoring of patients with long-term conditions.
• The surgery had systems and processes to keep people safeguarded from abuse.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
• Governance processes were in place but oversight of risk management to patient safety and providing effective services was not always fully embedded.

We found breaches of regulation. The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Oversight of systems and processes must be established and operated effectively to ensure compliance with the requirements of the fundamental standards.

The provider should also:

• Improve the uptake of cervical cancer screening to eligible patients.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services