Trent Valley Surgery

Updated 6 September 2023

Trent Valley Surgery is located in the village of Saxilby at:

85 Sykes Lane,

Saxilby,

Lincoln,

Lincolnshire,

LN1 2NU.

The practice has a branch surgery at

Main Street,

Torksey,

Lincoln,

Lincolnshire,

LN1 2EE.

There is a dispensary at the Saxilby site, and we inspected this as part of our inspection. The practice can dispense to 2016 patients which is 48% of the practice list.

The practice offers services from both a main practice and a branch surgery. Patients can access services at either surgery. During this inspection we visited both locations.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury, family planning and surgical procedures These are delivered from both sites.

The practice is situated within the Lincolnshire Integrated Care System and delivers General Medical Services (GMS) to a patient population of about 4,190. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices, known as Trent Care Primary Care Network (PCN) consisting of five practices covering a population of 40,000.

The practice has 2 partners, the finance manager and the lead GP with 3 salaried GPs. There are 2 advanced nurse practitioners, 3 practice nurses and 1 health care assistant. The practice also employs a practice manager, a dispensary manager and a team of reception, administration, dispensary staff, a secretary and a medicines delivery driver.

Information published by Public Health England shows that deprivation within the practice population group is in the eighth lowest decile (eight of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is, 98.8% White, 0.4% Asian, and 0.8% with a deprivation score of 8 on 1 April 2022. Data from Public Health England shows the practice has a higher than average elderly patient population and a higher number of patients with long term conditions when compared to the local and national average.

If the GP needs to see a patient face-to-face, then the patient is offered a choice of either the main GP location or the branch surgery.

Enhanced access is provided where late evening and weekend appointments are available from practices within the PCN.

Out- of- hours services are provided by Lincolnshire Community Health Services NHS Trust.

Updated 6 September 2023

We carried out an announced focused inspection at Trent Valley Surgery on 11 July 2023. Overall, the practice is rated as requires improvement.

Safe - requires improvement.

Effective – requires improvement.

Caring – not inspected rating of good carried forward from previous inspection.

Responsive - good.

Well-led - good.

Following our previous inspection on 7 September 2022, the practice was rated requires improvement overall and inadequate for providing safe services and requires improvement for providing effective and well- led services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Trent Valley Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection in line with our inspection priorities.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A shorter visit to the main and branch site.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• The practice had taken reasonable steps to protect patients and others from the risks.
• Staff received appropriate training and supervision.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• Managers understood the challenges to providing safe and effective care.
• Patients received care and treatment that met their needs.
• There was a focus on continual learning and improvement.
• The provider was trialling a new way to manage safety alerts, but further work was required in this area to help improve performance.
• Medicine reviews were not always conducted effectively.
• Patients with long term conditions were reviewed but further work was required in this area to help improve patient outcomes.

Whilst we found no breaches of regulations, the provider should:

• Take steps to improve coding relating to families of patients with a safeguarding concern.
• Take action to consolidate cleaning schedules and their completion by staff.
• Improve the process in relation to documentation and actions taken in relation to medicine reviews and long- term medicine management.
• Introduce a system to safely manage prescribed medication if a patient fails to attend for monitoring.
• Consolidate control of substances potentially hazardous to health (COSHH) data sheets and keep with the related substances.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care