Archived: Stanground Surgery Also known as Dr R M Scott and Partners

Updated 15 November 2016

Stanground Surgery is a purpose built practice situated in Peterborough, Cambridgeshire. The practice provides services for approximately 8000 patients. It holds a Personal Medical Services contract with Cambridgeshire and Peterborough Clinical Commissioning Group.

According to information taken from Public Health England, the practice population is in line with the national averages for practices in England. The practice is in an area with a mixed level of deprivation and a high level of residential developments.

The practice clinical team consists of seven GP partners, five salaried GPs, three GP registrars, a pharmacist, a nurse practitioner, three practice nurses, two healthcare assistants and two phlebotomists. They are supported by a practice manager, a deputy practice manager, and teams of reception, administration and secretarial staff.

Stanground Surgery is a training practice and supports trainee GPs (qualified doctors who are undertaking further training to become GPs). The practice has up to two trainee GPs working at any one time. The practice also supports the education of Foundation Year 2 doctors (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 2 doctors working at any one time. The practice also teaches medical students from the University of Cambridge.

Stanground Surgery is open from Monday to Friday. It offers appointments from 8am to 6pm daily. Extended hours appointments are available between 6.30pm and 9pm on Thursdays. In addition to this, patients registered at the surgery are able to access evening and weekend appointments at other local surgeries as part of the Prime Minister’s Challenge Fund. Out of hours care is provided via the NHS 111 service.

Updated 15 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stanground Surgery on 4 October 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• 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.
• Feedback from patients about their care was generally positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in July 2016 showed that patients rated the practice higher than others for several aspects of care.
• 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.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• There was a focus on continuous learning and improvement at all levels within the practice. The practice was a long standing training and teaching practice, which had led to successful GP recruitment and retention. A GP at the practice had recently been awarded the ‘Excellent Teaching Award’ by the University of Cambridge Clinical Students Society.
• The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 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 local and national averages of 89%. Exception reporting for diabetes related indicators was 20%, which was higher than the local 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.
• Patients with complex needs had a named GP and a structured annual review to check their health and medicines needs were being met. The practice had commenced a ‘Purple Clinic’ for patients with more than one long term condition. This was to provide holistic care and reduce patient need for multiple appointments.
• 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.
• The practice pharmacist offered support to patients with long term conditions. For example, explaining the use of medicines devices and ensuring that patients understood medicines regimes.
• The practice had a lead GP for avoiding unplanned admissions and multidisciplinary working.

Updated 15 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, for example, children and young people who had a high number of A&E attendances.
• Immunisation rates were high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 81%, which was in line with the local 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 and chlamydia screening.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The practice had close links with local Sure Start Centre who provided parenting classes for young parents.

Updated 15 November 2016

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

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. All home visits were triaged by a clinician to prioritise visits and ensure appropriate and timely intervention.
• GPs and nursing staff provided home visits to patients living in the five nursing homes covered by the practice.
• 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.
• The practice contacted all patients after their discharge from hospital to address any concerns and assess if the patient needed GP involvement at that time.
• The practice pharmacist reviewed medications for patients within this population group to avoid polypharmacy and to ensure safe transistion at points of care handover.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure, were above local and national averages.
• The practice had recognised 2.3% of patients as being at risk of hospital admission, which was above the local CCG target of 1.8%.

Updated 15 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 as well as a full range of health promotion and screening that reflects the needs for this age group.
• The practice offered the Web GP E-Consult service, which gave patients 24 hour access a GP by email with a response by 6pm the following working day. This service also safely directed patients  to self-care, pharmacy advice or disease specific information.
• Extended hours appointments were available between 6.30pm and 9pm on Thursdays.
• Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years. The practice was able to refer patients to a health trainer to encourage lifestyle changes.
• The practice offered many NHS services in house, reducing the need for outpatient referral and therefore improving patient convenience.

Updated 15 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, which was in line with the local and national averages of 84%.
• 94% of patients experiencing poor mental health had a comprehensive care plan, which was above the local average of 88% and the national average of 89%.
• 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, such as befriending and bereavement support.
• The practice had an in house counselling service for patients with additional mental health needs.
• 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.
• The practice had provided training on dementia awareness and the Mental Capacity Act 2005 to all members of staff to ensure that mental health and psychological wellbeing was considered at every contact.

Updated 15 November 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 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, and held regular multidisciplinary team meetings.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• The practice was engaged with the local Carers’ Prescription Service, which provided respite for carers. Written information was available to direct carers to the various avenues of support available to them.
• 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.