Archived: Tideswell Surgery

Updated 14 May 2015

Tideswell Surgery is a rural dispensing practice based in the Derbyshire village of Tideswell. The practice has approximately 3340 registered patients, the majority of whom are over the age of 65.

Parking for patients and staff is available at the practice and the building has single level access to aid people with reduced mobility, wheelchair users and parents/carers with pushchairs.

The practice staff consists of a male lead GP, and two female salaried GPs, six reception staff (who are also qualified to work in the dispensary), one female practice nurse, a nurse practitioner one phlebotomist (a staff member trained and skilled to taking blood samples), a practice manager and assistant practice manager. A pharmacy technician, team leader and senior reception manager were also employed at the practice.

The practice does not provide its own out-of-hours service but arrangements are in place for patients to be seen by Derbyshire Health United, when the practice is closed.

Updated 14 May 2015

Letter from the Chief Inspector of General Practice

We inspected this practice on 16 October 2014 as part of our new comprehensive inspection programme. This is the first time we have inspected this practice.

This practice has an overall rating of good and it was providing good quality care and treatment across all domains and population groups. We saw some examples of outstanding care.

• Patients told us they were satisfied with the appointments system and told us it met their needs.
• Patients were kept safe from the risk and spread of infection as the provider had carried out audits and acted on their findings
• Patients were treated with dignity and respect and spoken to in a friendly manner by all staff
• Systems were in place to keep patients safe by assessing risk and taking steps to reduce this. We saw evidence of learning from previous incidents.
• Patients, their relatives and carers were involved in all aspects of treatment and their opinions were listened to and acted upon.

We saw examples of outstanding practice. The practice is situated in a remote rural location with a dispersed patient group and limited access to public transport. We saw that action had been taken to ensure patients received the care they required, for example;

• The practice offered branch surgery sessions in three nearby villages to ensure all patients could access the service they required. Surgeries were held in village halls where patients could have simple health checks, consultations and request and collect prescriptions. Any more serious concerns could be dealt with at the main practice. Patients told us the valued this service and found it invaluable

• The lead GP carried out research into rates of depression and poor mental health amongst the rural community of North Derbyshire. Isolation and depression was identified as a major factor in rural communities. This led to the Farm out Project being developed to provide social and wellbeing activities for the local farming community. The project had proved very successful and was implemented across the CCG area

• The practice had developed health and lifestyle checks specifically designed for teenagers. This looked at vaccination status, physical health checks and lifestyle advice. It has proved so successful it has been rolled out across the Clinical Commissioning Group area.

However, there were areas of practice where the provider should make improvements.

The provider should:

• Ensure that audit cycles are completed by carrying out a second review of the subject

• The provider should ensure that curtains or screens are fitted in treatment rooms to further protect patients dignity

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 May 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 14 May 2015

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. Immunisation rates were high for all standard childhood immunisations with 100% of registered children receiving all immunisations by age five. 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.

Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors, school nurses and the local school. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

The practice had developed health and lifestyle checks specifically designed for teenagers. This looked at vaccination status, physical health checks and lifestyle advice. It has proved so successful it has been rolled out across the Clinical Commissioning Group area.

Updated 14 May 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 14 May 2015

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.

Updated 14 May 2015

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

An example of good practice was that the lead GP carried out research into rates of depression and poor mental health amongst the rural community of North Derbyshire. Isolation and depression was identified as a major factor in rural communities. This led to the Farm out Project being developed to provide social and wellbeing activities for the local farming community.

Everybody registered with mental health needs had an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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 including MIND, SANE and the Farm Out Project. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 14 May 2015

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 those with a learning disability. It had carried out annual health checks for people with a learning disability and 100% of these patients had received a follow-up. It offered longer appointments, with the same staff for continuity of care for people with a learning disability.

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