Dr A J Wills & Partners

Updated 26 April 2016

The Burwell Surgery is situated in Burwell, Cambridgeshire. The practice provides services for approximately 8100 patients. The catchment area includes Burwell, Exning, Fordham, Swaffham Prior, Reach and Swaffham Bulbeck. The practice is a training practice for doctors training to become GPs and for medical students. The practice has a dispensary attached. They hold a General Medical Services contract. The practice has three male GP partners, three female salaried GPs, one female GP registrar and three female practice nurses. They also employ one female healthcare assistant and one female phlebotomist, a practice manager, four dispensers and 12 part time reception/administration/secretarial staff.

The practice’s opening times are from 8.30am until 6pm Monday to Friday, with extended hours on Monday evenings from 6.30pm to 8.30pm. The practice has opted out of providing GP services to patients outside of normal working hours such as nights and weekends. During these times GP services are provided by Cambridgeshire out of hours service via the 111 service.

We reviewed the most recent data available to us from Public Health England which showed that the practice had an overall practice population comparable to national England average. The deprivation score was significantly lower than the average across England.

Updated 26 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 28 January 2016. Three breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to ensuring robust processes were in place for the following;

• Check the controlled drugs register against the physical stock at regular intervals in line with the Standard Operating Procedures.

• Ensure that the practice gains consent from patients identified as carers before their information is passed on to the carers group.

• Ensure that a confidentiality agreement has been signed by the carers group and documented by the practice.

• The practice must operate robust recruitment procedures, which include undertaking any relevant checks. Ensure appropriate checks through the Disclosure and Barring Service have been completed on all of the required staff, and a risk assessment completed where necessary.

The practice made information available to us. We undertook a desk top inspection to check that they had followed their plan and to confirm that they now met legal requirements. The overall rating for the practice is Good. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports' link for on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 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 practice used the information collected for the Quality and Outcomes Framework (QOF) and performance against national screening programmes to monitor outcomes for patients. QOF is a system intended to improve the quality of general practice and reward good practice. Data from 2014/2015 showed; Performance for diabetes related indicators was 83.7%, which was below the CCG average by 5.8% and the England average by 5.5%. Performance for asthma related indicators was 100%, which was better than the CCG average by 2.4% and the England average by 2.6%.

• Longer appointments and home visits were available to patients when needed.

• The practice offered longer appointments for health checks for patients needing long tem condition management.

• 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.

Updated 10 March 2016

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.

• The GPs telephoned new parents to provide support and advice.

• 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 practice’s uptake for the cervical screening programme was 87%, which was above the CCG and England average. The practice also used the appointment as an opportunity to consult patients about their sexual health and contraception.

• 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, health visitors and school nurses.

• The practice had a private room available for breast feeding.

• The dispensary participated in a scheme to supply free condoms to young people who held a registration card.

Updated 10 March 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 offered longer appointments for health checks for patients aged over 75.

• A GPs visited patients in local care homes and liaised with the care home managers.

• The practice provided flu clinics on weekdays and weekends in an effort to maximise the rate of vaccination in the high risk groups. The practice had organised a clinic at the local village Day Centre.

• Patients with ongoing care needs were discussed at Primary Health Care Team meetings, which took place twice a month. Patients’ notes were flagged with Special Patient Notes (SPNs), which alerted medical staff accessing the notes to the nature of their difficulties and ongoing issues. This included out of hours doctors and ambulance staff. All SPNs were reviewed every three months to ensure they were still relevant. The practice also reviewed their patients in hospitals to help plan care after they were discharged.

Updated 10 March 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. They operated extended hours on a Monday evening until 8.30pm. They offered telephone consultations during the day to patients that might not be able to access the surgery during normal hours.

• 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 offered health checks to eligible patients between the ages of 40-74.

• Telephone consultations offered at flexible times.

Updated 10 March 2016

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 with dementia.

• All patients with mental health concerns were offered an annual health check. The practice offered evening appointments outside of its core hours to maximise the opportunity for the patients to attend.

• 96.6% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the record, in the preceding 12 months which was 9.6% above the CCG average and 8.3% above the England average.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 might have been experiencing poor mental health.

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

Updated 10 March 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. They operated a call system to invite patients with learning disabilities in for an annual health check. They had 31 patients on the learning disability register. The practice offered all patients with learning disabilities longer appointments.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.