Tanners Meadow Surgery Also known as Brockwood Medical Practice

Updated 25 October 2016

Tanners Meadow Surgery, also known as Brockham Surgery, offers primary medical services to the population of Betchworth and the surrounding area. There are approximately 12,000 registered patients. The practice has two branch surgeries. One of which is able to dispense medicines to patients living in a one mile radius (as the crow flies) from the surgery.

Tanners Meadow Surgery is situated in a semi-rural location in Betchworth. The ground floor has disabled access with a seated waiting area situated away from the booking in desk. All of the GP consulting rooms and treatment rooms are located on the ground floor. Staff offices and facilities are located on the first floor. There is a toilet for patients with disabilities on the ground floor, which has baby changing facilities.

Tanners Meadow Surgery is run by five partner GPs (three male and two female). The practice is also supported by seven salaried GP (six female and one male), four practice nurses and two healthcare assistants. The practice also has a team of receptionists, administrative staff, dispensing staff and dispensing manager, a business manager, a deputy practice manager and a practice manager.

Tanners Meadow Surgery is a training practice for FY2 doctors. (FY2 doctors are newly qualified doctors who are placed within a practice for four months and will have their own surgery where they see patients).

The practice runs a number of services for its patients including asthma reviews, child immunisation, diabetes reviews, new patient checks and holiday vaccines and advice.

Services are provided from:-

The Main Surgery

Brockham Surgery, Tanners Meadow , Betchworth, Surrey, RH3 7NJ

Opening Times

Mon, Tues, Thurs, Fri 8am to 6.30pm and Wednesday 8am-5pm

And Branch Surgeries

Newdigate Surgery, (dispensing practice) Rusper Road, Newdigate, Surrey, RH5 5BE

Opening Times

Mon, Wed, Thu, Friday 8am - 6:30pm and Tuesday 8am - 5pm

North Holmwood Surgery, 1 Bentsbrook Close, North Holmwood, Surrey, RH5 4HY

Opening Times

Mon, Tues, Wed, Friday 8am - 6:30pm and Thursday 8am - 4pm

During the times when the both practices are closed, the practice has arrangements for patients to access care from an Out of Hours provider.

The practice population has a higher number of patients aged between 40 to over 85 years of age than the national and local clinical commissioning group (CCG) average. The practice population shows a lower number of patients aged birth to 4 years and 15 to 39 years of age than the national and local clinical commissioning group (CCG) average. The percentage of registered patients suffering deprivation (affecting both adults and children) is lower than the average for England. Less than 10% of patients do not have English as their first language.

Updated 25 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tanners Meadow Surgery on 13 September 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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.
• 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. 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.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice participated in the hospital admission avoidance scheme and maintained a register of patients who were at high risk of a hospital admission.
• The practice had given talks to local schools about the role of the GP surgery and had given some students the opportunity to complete work experience at the practice.
• The practiced worked closely with local services including the local food bank and volunteer transport schemes.
• The practice was involved on the Get It On Scheme. (Get it On is a service for under 24 year olds living in Surrey who can have access to advice about sex and relationships and receive free condoms).
• There were two branch practices which enabled patients ease of access in the rural area. One of the branch practices were able to dispense medicines to eligible patients

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 October 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 comparable with the local clinical commissioning group (CCG) and national averages. For example, 82% of patients with diabetes, whose last measured total cholesterol was in a range of a healthy adult (within the last 12 months). The national average was 80% and the clinical commissioning group (CCG) average was 81%.
• 95% of patients with chronic obstructive pulmonary disease (COPD) had a review undertaken including an assessment of breathlessness, which was comparable with the national average of 90%
• 73% of patients with asthma had an asthma review in the previous 12 months. This was in line with the national average of 75%
• The practice offered regular blood testing clinics for patients on the blood thinning medicine warfarin, to monitor risks associated with this medicine.
• 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.
• The practice website had information in relation to different long terms condition including information for asthma and diabetes.
• Two specialist diabetic nurses from Kingston hospital visited the practice every week.

Updated 25 October 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.
• The number of women aged between 25 and 64 who attended cervical screening in 2014/2015 was 79% which was comparable to the clinical commissioning group (CCG) and national average of 82%
• The practice ensured that children needing emergency appointments would be seen on the same day.
• The practice offered family planning and routine contraception services including implant/coil insertion.
• 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, health visitors and school nurses.
• The practice was involved on the Get It On Scheme. (Get it On is a service for under 24 year olds living in Surrey who can have access to advice about sex and relationships and receive free condoms).
• Practice staff had received safeguarding training relevant to their role and knew how to respond if they suspected abuse. Safeguarding policies and procedures were readily available to staff.
• The practice gave talks at local schools and had given some students the opportunity to complete work experience at the practice.

Updated 25 October 2016

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

• 37% of the practice population was over the age of 65, which was higher than the national average of 27% and the clinical commissioning group average of 32%. All of these patients had a named and accountable GP.
• The practice looked after patients at four nursing homes and two care homes.
• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• Older patients with complex care needs and those at risk of hospital admission had care plans that were appropriately shared with local organisations to facilitate the continuity of care.
• The practice was working to the Gold Standards Framework for those patients with end of life care needs. (The Gold Standards Framework is a framework to enable a standard of care for all people nearing the end of their lives. The aim of the Gold Standards Framework is to develop a locally-based system to improve and optimise the organisation and quality of care for patients and their carers in the last year of life)
• Results from 2015 showed that 20% of practice patients died in hospital compared with the national average of 53%, showing that a higher number of patients died in the setting of their choice.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice conducted a higher number of home visits due to poor transport links in the area. Patients were also given information about local transport schemes.

Updated 25 October 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.
• Electronic Prescribing was available which enabled patients to order their medicine on line and to collect it from a pharmacy of their choice, which could be closer to their place of work if required.
• The practice offered NHS health-checks and advice for giving up smoking.
• Clinics for family planning and routine contraception services were available at various times of the day.
• The practice offered advice by telephone each day for those patients who had difficulty in attending the practice.

Updated 25 October 2016

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

• 90% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, with the national average being 84%
• 91% of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented, in the last 12 months, with the national average being 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 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 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 was able to offer counselling services at the main surgery and one of the branch surgeries and cognitive behavioural therapy was available through Improving Access to Psychological Therapies (IAPT) at all three surgeries.

Updated 25 October 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 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.
• Translation services were available for patients who did not use English as a first language.
• The practice had a hearing loop for those patients with a hearing impairment.
• The practice could accommodate those patients with limited mobility or who used wheelchairs.
• Carers, and those patients who had carers, were flagged on the practice computer system and were signposted to the local services and the local carers support team.