Background to this inspection
Updated
20 December 2016
Hill Lane Surgery is located in a converted building at 162 Hill Lane, Southampton, SO15 5DD.
The practice has an NHS General Medical Services contract to provide health services to approximately 8500 patients in and around Shirley, and central areas of Southampton. The practice covers a mainly urban population and has a higher than national average for males and females aged 15 to 44 years.
The practice has five GP partners three male and two female. The practice has one practice nurse and two healthcare assistants.
The clinical team are supported by a practice manager and a team of eleven receptionists and administration support staff.
The practice is open Monday to Friday 8am to 6:30pm. Phone lines are open from 8am to 6pm Monday to Friday (excluding public holidays). The surgery is closed between 12.30pm and 1.30pm Monday to Friday.
GP appointments are available Monday to Friday with the GPs and the practice offered extended hours appointments most mornings between 7.30am and 8am, and one Saturday morning clinic in four.
Same day appointments can be booked at any time from 8am. Appointments could be made by phone, on line or by visiting the practice. The practice offered online booking for appointments and requesting prescriptions.
The practice offered telephone consultation appointments with the GP or nurses which could be arranged via the reception team. The practice also offered home visits if required and appointments with the practice nurses if the patient felt they did not need to speak with a GP.
The practice has opted out of providing out-of-hours services to their own patients and refers them to the Out of Hours service via the NHS 111 service.
Updated
20 December 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Hill Lane Surgery, 162 Hill Lane, Southampton, SO15 5DD on 21 September 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 for reporting and recording significant events.
- Risks to patients were assessed and well managed.
- Staff had the experience and had been trained to provide them with the skills and knowledge 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 on.
- The provider was aware of and complied with the requirements of the duty of candour.
- In 2015 the practice had identified that some patients’ results were not being received from another provider. The practice created a checking system to ensure all results were followed up and actioned. The practice found that there were gaps in all areas but mostly with external providers. This was reported to local clinical commissioning group and NHS England and as a result the external providers have initiated improvements to processes used. This has meant improved services for all patients in the area.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice.
People with long term conditions
Updated
20 December 2016
The practice is rated as good for the care of people with long-term conditions.
- Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
- The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12months) was 140/80 mmHg or less. (01/04/2014 to 31/03/2015) was 82% compared to the local clinical commissioning group at 80% and the national average at 79%.
- 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.
Families, children and young people
Updated
20 December 2016
The practice is rated as good for the care of families, children and young people.
- There were systems 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 (A&E) 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 percentage of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding 5 years (01/04/2014 to 31/03/2015) was 82% to the same as the local clinical commissioning group and national average.
- 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 and health visitors.
Updated
20 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.
- The practice worked together with the older people’s mental health team, for patients who required extra support for their mental health problems in the community. The practice offered dementia assessments and access to the memory clinic if this was required.
Working age people (including those recently retired and students)
Updated
20 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 reflected the needs for this age group.
- The practice annually advertised to the new intake student population and had many students who remained on the patient list.
- The practice provided health assessment appointments. In these appointments patients had their cardiovascular disease risk assessed and they had an opportunity for advice on all aspects of healthy living.
People experiencing poor mental health (including people with dementia)
Updated
20 December 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- sixty four percent of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is worse than the national average. This might have been be due to the number of days staff were away from work to due serious illness, accidents or authorised leave.
- The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 92% compared to the local clinical commissioning group of 88% and national average of 89%.
- The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
- The practice carried out advance care planning for patients 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 to follow up patients who had attended A&E where they might have been experiencing poor mental health.
- Staff had a good understanding of how to support patients with mental health needs and dementia.
- The practice had a counsellor based in the surgery and access to psychological services through the local improving access to Psychological therapies (IAPT) service, Steps to Wellbeing.
- The practice had recently made changes to the working of the practice, to make the experience for patients, attending the practice with dementia easier. As a result the practice received a dementia friendly surgery award.
People whose circumstances may make them vulnerable
Updated
20 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, travellers 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.