Archived: Lakeside Healthcare at The New Queen Street Surgery Also known as Dr R M Scott and Partners

Updated 8 June 2017

The New Queen Street Surgery is situated in Whittlesey, Cambridgeshire. The practice provides services for approximately 10,270 patients and operates from a purpose built surgery. The practice is able to offer dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. The practice building operates over two floors. A lift is available for access to the upper part of the building.

The practice has seven GP partners, three female and four male, and five female salaried GPs. The team includes eight nurses, three healthcare assistants, one phlebotomist, and a pharmacist. They also employ a practice manager, a deputy practice manager, medical secretaries and two lead dispensers. A team of 14 reception and administration staff support the practice manager and the lead dispensers.

The practice holds a General Medical Services (GMS) contract, and is a training practice with four GP trainers. A training practice has trainee GPs working in the practice; a trainee GP is a qualified doctor who is undertaking further training to become a GP. A trainer is a GP who is qualified to teach, support, and assess trainee GPs. The practice has up to two trainee GPs working in the practice at any one time.

The practice also supports the education for Foundation Year Two doctors. Foundation Year Two doctors are qualified doctors who undertake a four month placement in the practice to gain experience of primary care. The practice has up to two Foundation Year Two doctors at any one time. The practice also teaches medical students from Cambridge University.

The most recent data provided by Public Health England showed that the patient population has a higher than average number of patients up to the age of four and aged 60 to 69 compared to the England average. The practice has a lower than average number of patients aged between 20 to 24 and 35 to 39 compared to the England average. The practice is located within an area of medium deprivation.

The practice reception is open between 8am to 6pm Tuesday to Friday, and until 9pm on Mondays. GP appointments are available from 8.20am to midday and from 2pm to 5.30pm, Tuesday to Friday. On Mondays, appointments are available until 9pm. Nurse appointments are available from 8.20am to 1pm and from 2pm to 5.30pm Monday to Friday. Patients also have access to GP and nurse appointments from 6.30pm to 8pm Monday to Friday and from 9am to 5pm Saturday and Sunday at a central location in Peterborough. Patients from the practice can be booked an appointment through the practice computer system.

Updated 8 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The New Queen Street Surgery on 28 June 2016. The overall rating for the practice was good, and requires improvement in relation to providing safe services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for The New Queen Street Surgery on our website at www.cqc.org.uk.

This inspection was an announced desk-based review carried out on 23 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 28 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection. Overall the practice is rated as good, which includes providing safe services.

Our key findings were as follows:

• The practice had created and appointed to a new dispenser post for 27.5 hours per week to improve dispensing services.
• There was an effective system in place for reporting, recording, investigating, reviewing and learning from near misses in the dispensary.
• Dispensing standard operating procedures for dispensing medicines, including controlled drugs (CDs) and dispensary stock, had been reviewed and updated. (Controlled Drugs are medicines that require extra checks and special storage requirements because of their potential for misuse).
• Improvements had been made to ensure the dispensing process for medicines, including CDs was safe.
• The practice had established a system for checking that medicines in the dispensary were in date. We reviewed documented records that these checks had been undertaken. These included checks of the controlled drugs and that the controlled drug register had been completed appropriately.
• The practice had undertaken a planned fire drill in November 2016 and this had been documented. Future fire drills had been scheduled according to their fire safety policy.
• The arrangements for the safe storage of clinical supplies had been reviewed. These were now kept in a locked storage room, to minimise the risk of unauthorised access.
• The practice had increased the number of annual health checks undertaken for people with learning disabilities from 24% during 2014 to 2015 to 73% from 2016 to 2017. A dedicated administrator was now responsible for coordinating and booking the reviews. These were scheduled on the patient’s month of birth and a recall system was set up to monitor uptake. The practice had developed links with a learning disability link nurse who supported this work, which included the use of easy read information for inviting patients, informing them about the health check and a pre health check questionnaire.
• The practice had established systems to monitor the practice appointment system and had made changes to increase effectiveness. The practice now offered a broader range of appointment times throughout the day and week and had increased the number of telephone appointments available for patients. Patients also had access to GP and nurse appointments from 6.30pm to 8pm Monday to Friday and from 9am to 5pm Saturday and Sunday at a central location in Peterborough. Patients from the practice could be booked an appointment through the practice computer system.

At our previous inspection on 28 June 2016, we rated the practice as requires improvement for providing safe services as systems and processes relating to the dispensing of medicine, including Controlled Drugs, were not always followed. (Controlled Drugs are medicines that require extra checks and special storage requirements because of their potential for misuse). At this inspection we found that improvements had been made. Consequently, the practice is rated as good for providing safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 November 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) 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 99%, which was above the CCG average of 90% and the national average of 89%. Exception reporting for diabetes related indicators was 20%, which was higher than the CCG average of 13% and the national average of 11% (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 when needed.

• 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 14 November 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.

• Immunisation rates were in line or above CCG averages for standard childhood immunisations.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding 5 years was 81%, which was in line with the CCG and national averages of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice offered a full range of contraception services.

Updated 14 November 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 had a dedicated telephone line which was shared with staff from nursing homes, so that they were able to contact the practice quickly if necessary.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis, heart failure, and chronic obstructive pulmonary disease were above local and national averages.

Updated 14 November 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 such as online appointment booking and repeat prescription requests. The practice also offered a range of health promotion and screening that reflects the needs for this age group.

• The practice provided both telephone and sit and wait appointments. The practice also offered eConsult (a system where a patient is offered a discussion with an appropriate clinician 24 hours a day and then offers the option of a patient completed consultation perform which is passed electronically to the practice to be dealt with within one working day.) This system also offered for example, general and specific health advice.

• The practice offered pre-bookable appointments on Monday evenings this met the need of those patients who could not attend during the day.

Updated 14 November 2016

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

• 81% of patients diagnosed with dementia had received a face to face care review in the last 12 months, compared to the CCG and national average of 84%.

• 94% of patients experiencing poor mental health had a comprehensive care plan, which was above the CCG average of 87% and the national average of 88%.

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

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

Updated 14 November 2016

The practice is rated as good for the care of people whose circumstances make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients, and held monthly multidisciplinary team meetings.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Patients who were carers were proactively identified and signposted to local carers’ groups. The practice engaged with the local Family Carers’ Prescription scheme, a local CCG initiative that gave access to the Peterborough branch of the Carers Trust who were able to provide information and support for carers.

• 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. There was a lead member of staff for safeguarding.