Archived: St Lukes Surgery

Updated 19 October 2018

St Lukes Surgery is commonly known to patients as the St Lukes and Botley Surgeries. St Lukes Surgery is the registered location and Botley Health Care Centre is a branch site. St Lukes Surgery is based in Hedge End on the outskirts of Southampton. Botley Health Care Centre is in the nearby town of Botley. There are limited public transport links between the two. The practice (including the branch site) has a patient list size of approximately 12000 registered patients.

The Registered Provider is St Lukes Surgery.

The practice is registered to provide regulated activities which include treatment of disease, disorder or injury, surgical procedures, family planning, maternity and midwifery services and diagnostic and screening procedures. The practice operates from the main location;

St Lukes Surgery,

St Luke’s Close,

Hedge End,

Southampton,

Hampshire,

SO30 2US

and from the branch site;

Botley Surgery,

Botley Health Care Centre,

Mortimer Road,

Botley,

Hampshire,

SO32 2UG

We visited both the main location and branch site as part of this inspection.

The clinical team consisted of two GP partners, one salaried GP and two regular locum GPs. The nursing team consisted of two nurse practitioners and two nurses as well as two health care assistants. The clinical team were supported by managerial and administrative staff.

At the time of this inspection the practice was in the process of merging with another GP practice, the Living Well Partnership. GP partners from the Living Well Partnership were named, as well as the two GP partners at the practice, on the contract held with the Clinical Commissioning Group for being responsible for delivering services to patients. The merger was not reflected in the registration of the location, provider and partners. Senior managers had assumed responsibility for overseeing different areas of governance and leadership and had implemented an organisation hierarchy of line management and responsibility.

Over 95% of the St Luke’s Surgery practice population identify themselves as being White British. The practice is in an area of low deprivation. There is a slightly higher than average number of patients who are under 18 years old when compared to the local and national averages.

St Lukes Surgery was open from 8am until 6.30pm. Appointments were available during these times. The branch site, Botley Health Care Centre, was open between 8.30am and 1pm every Monday and Tuesday, between 8.30am until 12.30pm and 2pm until 5pm every Wednesday. The branch was open between 8.30am until 12.30pm and 1.30pm until 5pm every Thursday, and between 9.15am and 1pm every Friday. Extended hours appointments were available through the Eastleigh Southern Parishes Network (which the practice was part of). Patients could request an extended hours appointment by contacting the practice. When the practice is closed patients are directed to out of hours services by dialling the NHS 111 service.

Updated 19 October 2018

This practice is rated as requires improvement overall. (Previous rating February 2018 – Inadequate)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? - Good

We carried out an announced comprehensive inspection at St Lukes Surgery on 21/08/2018 to follow up on breaches of regulations. The practice had previously been inspected in February 2018, when it was rated Inadequate overall. Specifically, the practice was rated as inadequate for providing safe, effective, responsive and well-led services. The practice had been rated as good for providing caring services. The practice was placed in special measures.

At this inspection we found:

• There was a new approach to the running of the practice with an open and transparent approach to safety and an effective system in place for reviewing and recording areas for improvement.
• The practice was in the process of merging with another GP practice, the Living Well Partnership. The practice had commenced the merger with the Living Well Partnership in October 2017 to promote sustainability and to share services for patients. We found that the merger of shared systems and processes had almost been completed.
• Senior managers had assumed responsibility for overseeing different areas of governance and leadership and had implemented an organisation hierarchy of line management and accountability.
• The practice had implemented clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• There were gaps in staff training and not all staff had received an annual appraisal.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patient feedback regarding the ease of accessing care remained mixed. The practice had made some changes to improve access for patients but new systems were not embedded.
• Staff reported feeling well supported by leaders and there was a focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out duties.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Continue to review prescribing for some less recommended antibiotics to reduce the number of items prescribed, in line with local and national averages.
• Review processes which enable staff to access policies and procedures.
• Review registration to reflect changes made to the provider and partners.

This service was placed in special measures in February 2018. Sufficient improvements have been made such that St Lukes Surgery has now been rated as Requires Improvement. I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Updated 19 October 2018

Updated 19 October 2018

Updated 19 October 2018

Updated 19 October 2018

Updated 19 October 2018

Updated 19 October 2018