High Street Surgery

Updated 17 August 2017

The provider, High Street Surgery is a partnership and provides services under Primary Medical Services contract (PMS) for 7,872 patients within Rotherham CCG. The services comprise of the main site at High Street Surgery, The Surgery, Rotherham, S62 6LW and a branch surgery at Thorpe Hesley Clinic, off Slough Hall Avenue, Thorpe Hesley S61 2QU. The main site is a purpose built surgery in the village of Rawmarsh, which is two miles north of Rotherham. The second site is based in a purpose built shared health services building owned by Rotherham CCG in Thorpe Hesley, of which the practice rent two rooms. We visited both sites during this inspection.

All premises have access to car parking facilities; although the car parking at the main site is limited there is a free car park next door at the shopping centre.

There is level access available for wheelchairs and disabled toilet facilities.

The patient population is comparable to the national average and the practice is in an area identified as being one of in the fourth most deprived areas nationally.

This is a teaching practice for doctors who wish to train as GPs.

There are two GP partners and three salaried GPs supported by two nurse prescribers, a health care assistant and a phlebotomist. The management team consists of a business manager, assistant practice manager and reception supervisor and there is a team of reception staff and administration staff.

Reception is open 8.30am to 6.30pm Monday to Friday.

Appointments are available as follows;

The High Street Surgery - Monday, Tuesday and Thursday7am to 11am, Wednesday and Friday 8.30am to 11am and Monday to Friday 3.45pm to 6pm. The practice provides extended hours and is open for pre-booked appointments between 7am and 8am Monday, Tuesday and Thursday.

Thorpe Hesley branch surgery – Monday Tuesday, Wednesday and Friday 8.30am to 9.30 am and 3.45pm to 6pm and Thursday 7am to 9.30 am. This surgery operates a doctor triage service in the mornings.

When the practice is closed patients are directed to the NHS 111 service.

Updated 17 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at High Street Surgery on 5 October 2016. The overall rating for the practice was good with requires improvement for safety. The full comprehensive report on the 5 October 2016 inspection can be found by selecting the ‘all reports’ link for High Street Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 17 July 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 5 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

• Improvements had been made to the way significant events incidents were recorded, investigated and reviewed to ensure opportunities for learning were maximised.

• Actions taken in response to safety alerts had been recorded.

• Safety notices to identify the storage area for liquid nitrogen had been displayed.

• A risk assessment for the provision of emergency drugs at both sites had been completed.

• Systems had been improved to assist the provider to identify defects and stock issues related to emergency equipment.

• Staff had completed infection prevention and control training.

The practice had also made the following improvements:

• Information about duty of candour requirements had been provided and staff were knowledgeable about these requirement’s.

• The recruitment procedure had been further developed to include how training would be verified and gaps in employment history would be identified and managed.

• Arrangements for cleaning of carpets had been improved and we found the carpets in a clean condition.

• An action plan to address poor patient satisfaction with telephone access to the practice had been developed and implemented. The telephone system had been improved following an analysis of use with the telephony provider. The telephone system also allowed the practice to monitor calls and waiting times. Systems to enable the practice to text patients and for patients to be able to cancel appointments by text had also been implemented. The practice was also promoting booking on line and had provided information for patients relating to this. Pre-bookable telephone consultations had been implemented and additional, telephone on the day, access to speak to a GP was available 11.30am to 12 midday. Patient satisfaction had been reviewed by the practice and results showed improvement in patient experience and patients we spoke with were satisfied with access to appointments.

• Access arrangements to the main site for patients with a disability had been improved. A doorbell with a sign for patients had been installed so staff could be made aware if patients required help with the doors.

• The complaints information was displayed at the branch site.

However, there were also areas of practice where the provider should make improvements.

• Review processes to ensure all staff understand their role in monitoring and maintaining the cold chain for vaccines stored in the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 10 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.

• Performance for diabetes related indicators was 79%, 4% lower than the CCG average and 10% lower than the national average. However, data showed the practice performance was 100% in other areas and above CCG and national averages;

  • Asthma 100% (3% higher than CCG and national averages).

  • Osteoporosis 100% (26% higherthan CCG average and 19% higher than national average).

  • Heart failure 100% (4% higherthan CCG average and 2% higher than national average).

  • Rheumatoid arthritis 100% (5% higher than CCG average and 7% higher than national average).

• Longer appointments and home visits were available when needed.

• 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 10 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 comparable to others 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.

• 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 and health visitors.

Updated 10 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.

Updated 10 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 reflected the needs for this age group.

• The practice provided extended hours and the main site was open for pre-booked appointments between 7.00am and 8.00am Monday, Tuesday and Thursday.

Updated 10 November 2016

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

• Performance for mental health related indicators was 69%, 22% lower than the CCG average and 24% lower than the national average. Performance for depression was 100% which was 6% higher than CCG average and 8% higher than national average.

• 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.

• The practice hosted improving access to psychological therapy (IAPT) service and mental health practitioner and counsellor services.

Updated 10 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 homeless people, 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.

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

• Staff knew how to recognise signs of abuse in 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.