Dr Spencer and Partners Also known as Burton Latimer Medical Centre

Updated 29 June 2017

Dr Spencer and Partners situated at Higham Road, Burton Latimer, Northamptonshire is a GP practice which provides primary medical care for approximately 13,520 patients living in Burton Latimer and the surrounding areas. There is a branch, the Finedon Surgery, situated in Regent Street, at the nearby village of Finedon. The practice maintains one patient list and patients can consult at any of the above locations. We did not inspect the Finedon branch at this time.

Dr Spencer and Partners provide primary care services to local communities under a General Medical Services (GMS) contract, which is a nationally agreed contract between general practices and NHS England. The practice population is predominantly white British along with a small ethnic population of Asian and Eastern European origin.

The practice has four GPs partners (two female and two male). There are four advanced nurse practitioners and three practice nurses. The nursing team is supported by a health care assistant and a phlebotomist. There is a practice manager who is supported by a team of administrative and reception staff. The local NHS trust provides health visiting and community nursing services to patients at this practice.

The practice operates out of a purpose built building. Patient care is provided on the ground floor as well as on the first floor which can be accessed by stairs or lift. There is a car park outside the surgery with adequate disabled parking available.

The practice is open Monday to Friday from 8am to 6.30pm. The practice offers extended opening on Monday until 7.30pm and on Tuesday from 7.30am. On Saturday the practice is open from 8am until and 10.30am. There are a variety of access routes including telephone consultations, on the day appointments and advance pre bookable appointments.

When the practice is closed services are provided by Integrated Care 24 Limited via the 111.

Updated 29 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Spencer and Partners on 23 May 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 a system in place for reporting and recording significant events. Lessons learnt were shared to make sure action was taken to improve safety in the practice. Staff we spoke with confirmed lessons were shared however we did not see documentation that supported these discussions had taken place.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. They used clinical tools available on the electronic patient records and a system called Pathfinder to deliver care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. However some aspects of nurse interactions with patients and access to care and treatment were rated below the local and national averages.
• 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 we spoke with said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.
• The practice had systems to support carers.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a leadership structure and staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The practice engaged with the patient participation group (PPG). However the PPG felt their skills could be further utilised in many aspects of patient care delivery and satisfaction.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Continue to ensure significant events and incidents are discussed at staff meetings and minutes reflect discussions on lessons learnt and changes implemented as a result.
• Continue to monitor and ensure improvement to national GP patient survey results.
• Ensure effective arrangements are in place to seek feedback from patients via patient participation group discussions and friends and family test.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 June 2017

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

• Nursing staff supported by GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• There was a system to identify patients at risk of hospital admission that had attended A&E or the out of hours service and these patients were regularly reviewed to help them manage their condition at home.

• Performance for diabetes related indicators were comparable to the CCG and national average. For example the percentage of patients with diabetes, on the register, in whom the last blood glucose reading showed good control in the in the preceding 12 monthswas 87%, compared to the CCG average of 71% and thenational average of 78%.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health. For example patients with severe COPD who were prone to rapid deterioration were offered access to rescue medicines which are a supply of standby medicines to start if the COPD got worse before the patient was able to see a GP.

• 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 more complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 29 June 2017

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.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

• The practice’s uptake for the cervical screening programme was 81%, which was the same as the CCG and national average.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

• The practice offered referrals to family planning and related screening such as chlamydia screening.

Updated 29 June 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• Patients over 75 had a named accountable GP and were offered the over 75 health check by a dedicated nurse.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. For example eligible older people were offered flu and shingles vaccines.

• The practice supported three local care homes and visited regularly to provide healthcare for the residents.

Updated 29 June 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.
• Early morning and late afternoon appointments were available which supported patients who were unable to attend the practice during normal hours.

• The practice was open on Saturday from 8am until and 10.30am.

• The practice had enrolled in the Electronic Prescribing Service (EPS). This service enabled GPs to send prescriptions electronically to a pharmacy of the patient’s choice.

• 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.

• A text message reminder system was used so patients could be reminded of forthcoming appointments or sent a short message for example about a normal test result. Patients were also able to cancel appointments using this service.

Updated 29 June 2017

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

• The practice carried out advance care planning for patients living with dementia.

• The percentage of patients diagnosed with dementia whose care plan has been reviewed in a face-to-face review in the preceding 12 months was 95% where the CCG average was 91% and the national average was 89%.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• The percentage of patients with diagnosed psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 88% where the CCG average was 91% and the national average was 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• The practice had told patients experiencing poor mental health about how to access support groups and voluntary organisations including the community drugs and alcohol team.
• Patients could access the Wellbeing Team provided by the local community mental health trust at the practice.
• The practice had a system in place to follow up patients who had attended A&E 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.

Updated 29 June 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.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• 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 had information available for vulnerable patients about how to access support groups and voluntary organisations.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.

• The practice identified patients who were also carers and signposted them to appropriate support. The practice had identified 189 patients as carers (approximately 1.5% of the practice list). The practice had identified a carer’s champion who provided information including a carer’s pack and directed carers to the various avenues of support available to them. The practice offered carers health checks and flu vaccinations.