Vine Street Surgery

Updated 4 August 2016

Vine Street Surgery is a GP practice, which provides primary medical services to approximately 7,180 patients living within the town of Grantham. South West Lincolnshire Clinical Commissioning Group (SWLCCG) commission the practice’s services.

The practice has a GP partner, two salaried GPs and a long-term locum GP. (three male and one female). The nursing team consists of three nurse practitioners (one is a nurse partner), two practice nurses and a healthcare support worker. They are supported by a Practice Manager and a team of reception staff and administrative staff.

The practice is open between 8am and 6.30pn Monday to Friday. Appointments are available between 8am and 1pm and from 1.50pm til 5.40pm. Telephone consultations are also available.

Patients can access out of hours support from the national advice service NHS 111. The practice also provides details for the nearest urgent care centres, as well as accident and emergency departments.

Updated 4 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Vine Street Surgery on 14 July 2016. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events

• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

• The practice was visibly clean and had comprehensive infection prevention and control procedures in place.

• Staff assessed needs and delivered care in line with current evidence based guidance.

• Applicable guidance from the National Institute for Health and Care Excellence (NICE) were summarised by staff and presented at practice meetings.

• Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

• Patients were supported and encouraged to live healthier lives.

• Patients said they were treated with dignity and respect, they were listened to and they were involved in decisions about their care and treatment.

• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

• The practices’ care co-ordinator carried home visits to those unable to visit the practice to complete annual reviews and routine checks for those with a long-term condition.

• Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff.

• The practice had a clear vision and objectives to aid the delivery of the vision. Staff were clear about the vision and their responsibilities in relation to it.

• The provider was aware of and complied with the requirements of the duty of candour.

• The practice sought feedback from staff and patients, which it acted on.

The area where the provider should make improvement is:

• The number of telephone lines to improve patient access by phone.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 August 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.

• 83% of those with diabetes had a blood test to assess diabetic control (looking at how blood sugar levels have been averaging over recent weeks) which showed that their control was good  (HBa1c 64 or less) compared to a national average of 78%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and were offered 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 and care co-ordinator worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 4 August 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.

• Immunisation rates were relatively high for all standard childhood immunisations.

• Patient feedback told us that children and young people were treated in an age-appropriate way.

• The practice’s uptake for the cervical screening programme was 76%, which was comparable to the CCG average of 78% and the national average of 74%.

• 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.

• The practice hosted antenatal clinics which were held on a weekly basis.

Updated 4 August 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.

• All patients over the age of 75 were informed of their named accountable GP.

• The practice attended neighbourhood team meetings to discuss the needs of older people, this included representatives from mental health teams, social services and the independent living team.

• All housebound patients and patients living in a residential or nursing home were reviewed by the care co-ordinator.

Updated 4 August 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.

• The practice was proactive in offering online services, including online appointment booking and repeat prescription requests.

• A full range of health promotion and screening was offered that reflected the needs for this age group.

Updated 4 August 2016

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

• 92% of those with a diagnosis of schizophrenia, bipolar affective disorder or other had a comprehensive and agreed care plan in place, compared to the national average of 88%.

• 89% of patients with a diagnosis of dementia had their care reviewed in a face-to-face review, compared to the national average of 84%.

• 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 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.

• Individual care plans were written jointly by the GP, patient and carer and a copy was kept by the patient.

Updated 4 August 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 those with a learning disability.

• The practice offered longer appointments for patients with a learning disability and an annual health check.

• 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, including counselling and drug and alcohol services.

• The practice had systems in place for patients living in vulnerable circumstances, including homelessness, to ensure if a referral to secondary care was required, correspondence could be sent to the practice.

• 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.