Fleggburgh Surgery

Updated 4 February 2016

Fleggburgh surgery is situated in Fleggburgh, Norfolk within a small village. The practice is accessible by public transport. The practice is one of 25 GP practices in the NHS Great Yarmouth & Waveney CCG area. The practice has a personal medical services (PMS) contract with the NHS and undertakes minor surgical procedures. There are approximately 1898 patients registered at the practice.

The practice has one GP with a locum GP providing cover when that GP is not available. The GP has lead responsibilities and management responsibility in addition to clinical duties.

The GP was supported by three nurses and phlebotomist. There is a practice manager, a team of receptionists and a number of support staff who undertake various duties. There is a dispensary manager and two dispensers who work within the practice. All staff at the practice work a range of different hours including full and part-time.

The surgery is open Monday to Friday between 8.00 and 6.00pm. Surgeries run in the mornings and afternoons each day. The practice has opted out of providing 'out of hours’ services which is now provided by another healthcare provider. Patients can also contact the emergency 111 service to obtain medical advice if necessary.

There has been no information relayed to us that identified any concerns or performance issues for us to consider an inspection. This is therefore a scheduled inspection in line with our national programme of inspecting GP practices.

Updated 4 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fleggburgh surgery on 18 November 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for older people; people with long-term conditions; families, children and young people; working age people; people whose circumstances may make them vulnerable and people experiencing poor mental health.

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.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with their GP and that 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.
• 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure that clinical waste bins stored outside are secured to prevent removal.

• Comply with practice action plan to improve infection prevention and control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 February 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. For example COPD, asthma and diabetes.

• Longer appointments and home visits were available when needed.

• All patients with a long-term condition had their own GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 4 February 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.

• 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.

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

• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 4 February 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.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice had instigated a geriatric questionnaire for the over 75s.

• The dispensary offered home deliveries for patients who find it difficult to collect prescriptions.

Updated 4 February 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.

• There were flexible appointments available for each week to cater for working age people.

Updated 4 February 2016

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

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  The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• It carried out advance care planning for patients with dementia including devising a questionnaire to help confirm a diagnosis by allied health professionals.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• It 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 people with mental health needs and dementia.

Updated 4 February 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.

• It offered longer appointments for people who needed them.

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

• It had told 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.