Grove View Integrated Health Hub

Updated 26 May 2016

The Priory Gardens Surgery provides a range of primary medical services, including minor surgical procedures from purpose built premises on Church Street in Dunstable. The practice serves a population of 9,549 patients, with slightly higher than average populations of males and females aged between 50 to 54 years and babies. There are slightly lower than average populations of males and females aged 35 to 44 years and 70 to 74 years. The practice population is largely white British. National data indicates the area served is one of medium deprivation.

The practice had recently experienced some difficulties with recruitment and retention of staff, with the retirement of long standing members of staff, including the practice manager and several of the GPs. They had struggled to retain new staff and were reduced to two partners from four, whilst simultaneously witnessing the departure of several members of their nursing team. This lead to a difficult period of recruitment coupled with staff shortages. However, they advised us that their staffing levels had now stabilised. The clinical team now consists of three male GP partners, three female salaried GPs, two nurse practitioners, two practice nurses and two health care assistants. The clinical team is supported by a practice manager, an office manager and a team of administrative support staff. The practice holds a General Medical Services (GMS) contract for providing services.

The practice is open between 8am and 6.30pm Monday to Friday. In addition to these times the practice operates extended surgery hours on Saturdays from 8.30am to 12.30pm. Patients requiring a GP outside of normal hours are advised to phone the NHS 111 service.

Updated 26 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Priory Gardens Surgery on 5 April 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 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.
• Patients said they found it easy to make an appointment, with urgent appointments available the same day.
• The practice had reasonable 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.

We saw one area of outstanding practice:

• Patients across the locality were able to utilise the practice’s deep vein thrombosis (DVT) service, which provided testing for patients at risk of developing blood clots.

The areas where the provider should make improvement are:

• Ensure that all staff receive regular appraisals.
• Ensure that newly developed systems for monitoring blank prescription pads are maintained and regularly reviewed.
• Develop systems to identify and support more carers in their patient population.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 May 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 similar to the CCG and national average. For example the percentage of patients with diabetes, on the register, who had received an influenza immunisation in the preceding 12 months, was 95% which was comparable to a national average of 94%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and were invited for 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 26 May 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.
• The percentage of patients with asthma, on the register, who had received a review in the period April 2014 to March 2015, was 76% which was comparable to the national average of 75%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 77%, which was comparable to the national average of 82%.
• 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.
• Contraceptive and sexual health advice was provided.

Updated 26 May 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.
• The practice offered memory screening services to the elderly.

Updated 26 May 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 on line services as well as a full range of health promotion and screening that reflects the needs for this age group.
• Patients were able to book appointments and update details online.

Updated 26 May 2016

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

• There were 63 patients on the dementia register of which 47 had received face to face reviews in the last 12 months.
• Performance for mental health related indicators was better than the national average. For example, the percentage of patients with diagnosed psychoses who had a comprehensive agreed care plan was 98% where the national average was 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those 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.

Updated 26 May 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 those with a learning disability.
• Electronic records alerted staff to patients requiring additional assistance.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.