Crosby House Surgery

Updated 28 December 2016

Crosby House Surgery is situated in Slough. The practice resides in an adapted building with car parking for patients and staff. There is access for patients and visitors who have difficulty using steps. All patient services are offered on the ground and first floors. The practice comprises of three consulting rooms, three treatment rooms, one patient waiting area, administrative and management offices, and a meeting room which is sometimes used as a consulting room.

The practice has approximately 11,100 registered patients. The practice population of patients aged between zero and nine and, 20 and 44 years is higher than national averages and similar to the clinical commissioning group (CCG) averages (a CCG is a group of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services). There were mixed levels of deprivation in the practice catchment area. Approximately 34% of patients were white British, 52% Asian, 9% black with 6% patients of a non-white British background.

There are two partners and four salaried GPs at the practice. Two GPs are male and four female. The practice employs three practice nurses. The practice manager and finance and complaints manager are supported by a team of administrative and reception staff. The practice is a training practice. Services are provided via a General Medical Services (GMS) contract.

Services are provided from the following location:

Crosby House Surgery,

91 Stoke Poges Lane,

Slough,

SL1 3NY.

The practice is open routinely between 8am to 6.30pm from Monday to Friday. Extended surgery hours are offered at the following times: 7.30 am to 8am on Monday and Tuesday, 6.30 pm to 8pm on weekdays, and weekends from 9am to 1pm.

Appointment times are:

• Mondays from 7.30am to 12pm and 2pm to 8pm;

• Tuesdays from 7.30am to 12pm, 2pm to 6pm and 6.30pm to 8pm;

• Wednesdays and Fridays from 8.30pm to 12pm, 2pm to 6pm and 6.30pm to 8pm;

• Thursdays from 8.30am to 12pm, 2pm to 5.30pm and 6.30pm to 8pm;

• Saturdays and Sundays from 9am to 1pm.

The practice had obtained funding to provide 48,000 additional appointments jointly with other Slough practices. This enabled Crosby House Surgery’s patients and patients from other practices to be seen at evening and weekends. However, clinical staff from Crosby House Surgery only saw patients from their own practice. The other practices were responsible for providing their own administrative support.

When the surgery is closed patients can access East Berkshire Out of Hours Service by calling NHS 111.

Updated 28 December 2016

Letter from the Chief Inspector of General Practice

We carried out an unannounced comprehensive inspection at Crosby House Surgery on the 25 October 2016. This was to follow up on concerns identified at an inspection in January 2016, where the practice was rated as requires improvement overall with an inadequate rating in the well led domain. Following the inspection on the 25 October the overall rating for the practice is good.

Our key findings across all the areas we inspected were as follows:

• The practice had acted on the findings of the previous inspection and had completed all the actions from their action plan.
• Crosby House Surgery had undergone a significant refurbishment since the last inspection. This included complete redecoration; new flooring throughout the practice, the installation of new furniture and other practice facilities has been updated.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• 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.

The areas where the provider should make improvement are:

• Display the out of hours contact details on the front door of the building, for patients who may visit the practice when they are closed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 December 2016

The practice is rated as good for the care of patients 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.

• Performance for diabetes related indicators was 96% which was similar to the clinical commissioning group average and the national average of 90%.

• 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.

Updated 28 December 2016

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

• 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 patients 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 patients 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 80% which was comparable to the clinical commissioning group average of 77% and the national average of 82%.

• 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 28 December 2016

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

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

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

• Performance for diabetes related indicators was 96% which was similar to the clinical commissioning group (CCG) average and the national average of 90%.

• Performance for chronic obstructive pulmonary disease (a chronic lung disease) related indicators was 100% which was similar to the CCG average of 98% and the national average of 96%.

• The practice provided medical support to two local care homes and undertook weekly visits to review the residents’ healthcare needs.

Updated 28 December 2016

The practice is rated as good for the care of working-age patients (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 to patients until 8.30pm each weekday evening and on Saturdays and Sundays between 9am and 1pm.
• There were online services for patients to book appointments or order repeat prescriptions.

Updated 28 December 2016

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

• 79% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 83%.

• Performance for mental health related indicators was 99%, which is similar to the clinical commissioning group average of 98% and national average of 92%.

• 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.

Updated 28 December 2016

The practice is rated as good for the care of patients 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.