Wansford & Kings Cliffe Practice Also known as Wansford & King's Cliffe Practice (Other Name: Wansford Surgery)

Updated 20 October 2016

Wansford Surgery is situated in Wansford, Peterborough, Cambridgeshire. The practice provides services for approximately 7300 patients. It holds a General Medical Services contract. The practice has a branch surgery in Kings Cliffe.

The practice has two GP partners (one male, one female) and four salaried GPs (two male and two female). The team also includes two female practice nurses, three female health care assistants and two community practitioners. They also employ a practice manager and a team of dispensary/reception/administration/secretarial staff.

The practice is a training practice and regularly trains qualified doctors to becoming a GP. Three GPs within the practice are trainers. There is a separate pharmacy on site. The practice’s opening times are from 8am until 6.30pm Monday to Friday, with extended hours on Tuesday evening from 6.30pm until 8pm. The practice provides Saturday morning access for urgent appointments with a GP.

The practice has opted out of providing GP services to patients outside of normal working hours. During these times GP services are provided by Herts Urgent Care via the 111 service.

We reviewed the most recent data available to us from Public Health England which showed that the practice had a lower than average practice population under 40 years and a higher than average practice population aged 40-70 years than national averages. The deprivation score was lower than the national average.

Updated 20 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wansford Surgery on 22 April 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 and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
• Urgent appointments with a GP were available on the same day.
• Information about services and how to complain was available and easy to understand.
• 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 practice was aware of and complied with the requirements of the Duty of Candour.
• There were not robust arrangements for identifying, recording and managing risks, issues and implementing mitigating actions. For example; prescriptions were not tracked and fridge temperatures were not monitored regularly.

The areas where the provider must make improvements are;

• The practice must ensure all medicines needing cold storage are monitored and kept at an appropriate temperature.
• The practice must ensure the dispensary is secure at all times.
• Ensure prescriptions are signed by a GP before collection by the patient.
• Ensure all medical consumables are within their expiry date.

The areas where the provider should make improvements are;

• The practice should be proactive in identifying carers.
• Ensure prescription forms are tracked and there is a system to monitor their use.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 June 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.
• 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 that performance for diabetes related indicators was 89% which was below the CCG and England average by 1% with an 11.9% exception reporting compared to the CCG average of 12.9%. Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects.
• Longer appointments and home visits were available to patients when needed.
• The practice offered health checks for patients who needed 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 22 June 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. Children and young people’s safeguarding meetings were held regularly with health visitors and safeguarding was a standing agenda for the weekly GPs’ meetings. GPs and nurses were safeguarding level three trained (safeguarding children and young people).
• Immunisation rates were generally in line with local and national averages for the 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 practice’s uptake for the cervical screening programme was 77%, which was below the CCG and England average by 5%.
• 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 mothers who were breast feeding.

Updated 22 June 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 health checks for patients aged over 75.
• GPs regularly visited patients in three care homes and liaised with the home managers.
• 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 end of life care.

Updated 22 June 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 operated extended hours opening on a Tuesday evening from 6.30pm until 8pm. They offered telephone consultations during the day to patients that might not be able to attend the surgery during normal hours. Appointments could be booked in advance and the practice offered same day urgent appointments.
• The practice offered online appointments and prescription requests as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 22 June 2016

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

• The practice carried out care planning for patients with dementia.
• 69% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was below the CCG and the England average by 15%.
• 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 including patients seen during out of hours. The practice and the out of hours service used the same clinical computer system and could access information about patients when needed.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 22 June 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 had identified 13 patients with a learning disability and eight had received an extensive health check in the previous 12 months. The practice referred patients to various support services and had regular liaisons with the local learning disability nurses.
• 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.