Ixworth Surgery

Updated 27 April 2017

Ixworth surgery is located in a rural village. Included in the practice catchment area is RAF Honington. There is poor public transport in the area and volunteer drivers make regular calls to the surgery as part of the local patient transport service funded by donations or on occasion, a small charge is made.

The practice list size is 9,000 of which there is higher proportion of patients aged 50 – 85 than the England average. The practice has a smaller proportion of patients aged 20 – 39 years of age.

• The practice has a branch surgery at Stanton that all patients can access if they wish. There is parking available at both sites. Internet access is available to patients at Ixworth.

• There are six GPs (three male, three female). The nursing team consists of two nurse practitioners, a respiratory nurse specialist, three practice nurses and a healthcare assistant. The practice is supported by a management team, medical secretaries, receptionists, data team, administrators and a pharmacy/dispensing team.

• The practice provides a range of services including midwifery, health visiting, child health clinic, orthoptist clinic, flu clinics, minor surgery, immunisation and contraceptive advice.

• The opening times are: Monday to Friday 8am – 6.30 pm. When the surgery is closed the out of hours cover is provided by Care UK through the NHS 111service.

• The practice is an accredited training practice for medical students.

The practice, being aware of green issues had installed solar panels, LED lighting (light emitting diode), and under floor heating in an attempt to reduce its carbon footprint.

Ixworth surgery is located at Peddars Close, Ixworth, Bury-St-Edmunds, Suffolk IP31 2HD.The branch surgery is at Stanton Health Centre, 12, The Chase, Stanton, Bury-St-Edmunds, Suffolk IP31 2XA.

Updated 27 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ixworth Surgery on 5 December 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 in place for reporting and recording significant events which were discussed at monthly meetings.
• Risks to patients were assessed and well managed and comprehensive risk assessments had been carried out.
• 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 on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The practice specialist respiratory nurse had developed a comprehensive personal asthma action plan and a chronic obstructive pulmonary disease (COPD) plan to highlight to patients how to identify various stages of their condition including how to take their medication and whether intervention was required. Audits undertaken showed that performance was above average for the control of patients with asthma and COPD.In the adult asthma audit, 90% of the practice’s population of adult asthmatics demonstrated good control, compared to only 60% in other practices in the audit.

The area where the provider should make an improvement is:

• Continue to monitor diabetes data and respond to outlying figures to achieve improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 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 and patients at risk of hospital admission were identified as a priority.

• The practice diabetic nurse provided specialist clinics and home visits for patients with long term conditions.

• Performance for diabetes related indicators was 63% which was 29% below the CCG average and 27% below the national average. The practice should continue to review and monitor the control of patients with diabetes.

• The practice respiratory nurse provided specialist clinics at the practice and home visits for asthmatic and COPD patients.

• Longer appointments and home visits were available when needed.

• Patients with long term conditions 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.

Updated 27 April 2017

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

• There were systems in place 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 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 has been performed in the preceding 5 years was 87% compared to the CCG average of 82% and the national average of 82%.

• A range of appointments were available throughout the day including urgent appointments, and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• A monthly orthoptist clinic could be accessed by referral from the GPs.

• Chlamydia testing was available.

Updated 27 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. Home visits were carried out by the doctors and nursing staff to administer flu vaccinations together with annual reviews if required.

• Home visits were also available for patients unable to attend the surgery and appointments were offered at times suitable for the elderly.

• A hearing aid clinic was available at the practice.

• Physiotherapy clinics were available at the practice

• Phlebotomy services were available for all patients each morning and two afternoons a week meaning that patients did not have to travel to hospital for this procedure.

Updated 27 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.

• Appointments were available with the GPs and also the nurse practitioners which included pre-bookable and sit and wait appointments.

• Contraceptive services were available including the fitting of coils and implants.

• Telephone and face to face appointments were available daily from 8am which the practice found were more suitable for working age patients.

Updated 27 April 2017

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

• The percentage of patients diagnosed with dementia whose care plan had been reviewed in a face-to-face review in the preceding 12 months was 77%

• Performance for mental health related indicators was comparable to the CCG and national average. For example the percentage of patients on the practice register experiencing poor mental health who have a record of blood pressure in the preceding 12 months was 89% which was 0.3% above the CCG average and 1% above the national average. Exception reporting for these indicators was 12.5% which was 3% below the CCG average and 0.2% below the national average.

• 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 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 and an ex-employee ran a carers group in the local café.

• A mental health practitioner attended the surgery on a weekly basis.

Updated 27 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.

• 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 including regular multi-disciplinary and palliative care meetings.

• 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.