Summercroft Surgery

Updated 9 January 2018

Summercroft Surgery is located in Orpington in the London Borough of Bromley. The practice serves approximately 11,300 people living in the local area. The local area is relatively affluent. The practice has higher than average numbers of people over the age of 65 years registered for services.

The practice operates from a single site. It is situated in purpose-built premises with a ground and first floor. There are ten consulting rooms the ground floor. The premises are fully wheelchair accessible with level access at the entrance and an accessible toilet on site there is a lowered desk, automatic doors and a hearing loop. There is also a car park for patients to use, including dedicated disabled parking bays.

There are six GP partners (four female, two male) as well as one salaried GP (male), four practice nurses and a healthcare assistant. There is also a regular locum GP. Overall the practice provides 46 GP sessions each week. The practice also employs a range of non-clinical support staff comprising a practice manager, an assistant practice manager, an accounts manager, a medical secretary, two prescription clerks, three administrators and eleven receptionists.

The practice offers appointments on the day and books appointments up to two weeks in advance. The practice has appointments from 8am to 6.30pm Monday to Friday. The practice also offers extended opening hours on Saturdays from 8am to 11am. Patients who need attention outside of these times are directed to call the 111 service for advice and onward referral to other GP out-of-hours services. The practice is also part of the Bromley GP Alliance. This provides access to GP appointments up until 8pm on weekdays, and until 8pm at weekends, at various GP practice locations throughout Bromley as part of a primary care hub agreement.

Summercroft Surgery is contracted by NHS England to provide Personal Medical Services (PMS). The practice provides GP services commissioned by NHS Bromley Clinical Commissioning Group (CCG). The practice is registered with the Care Quality Commission (CQC) to carry out the following regulated activities: Diagnostic and screening procedures; Family planning; Maternity and midwifery services; Surgical procedures; Treatment of disease, disorder or injury.

Updated 9 January 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Summercroft Surgery on 9 June 2016. As a result of our findings during that visit the provider was rated as good overall and requires improvement for providing safe services. The full comprehensive inspection report from that visit was published on 2 August 2016 and can be read by selecting the ‘all reports’ link for Summercroft Surgery on our website at www.cqc.org.uk.

The provider submitted an action plan to tell us what they would do to make improvements and meet the legal requirements. We undertook an announced comprehensive follow-up inspection on 31 October 2017 to check that the provider had followed their plan, and to confirm that they had met the legal requirements. As a result of our findings the provider is rated good. 

Our key findings were as follows:

• All staff had completed adult and child safeguarding training appropriate to their level.

• The practice had carried out a Legionella risk assessment and infection control audit which had not been conducted at the previous comprehensive inspection.

• The practice was able to demonstrate that they had obtained evidence of immunisation for several key staff which was not demonstrated at the pervious inspection.

• The practice had carried out a health and safety risk assessment and fire assessment which had not been conducted at the previous inspection.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.

• Although there was a process in place for the collection of prescriptions some staff members were unsure of it.

• Not all staff had undertaken role appropriate training, specifically infection control and information governance.

• Communication was not effective, although regular staff meetings were conducted staff spoken to on the day were unsure of some systems and processes.

There were areas where the provider should make improvements.

The provider should:

• Monitor action on processes and policy and also keep appropriate notes on patients’ files when deviating from policy or guidance.

• Review training to ensure all staff members have completed role specific training.

• Consider how best to ensure staff are aware of the practice’s prescription collection processes.

• Continue to review and improve how patients with caring responsibilities are identified and recorded on the clinical system to ensure that information, advice and support is made available to them.

• Conduct a risk assessment for emergency medicines.

• Consider reviewing communication with staff with a view to make it more effective.

• Continue to review patients access in relation to GP patient survey results.

• Improve diabetes performance.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 9 January 2018

The practice is rated as good for the care of people with long-term conditions. 

• The nurse and GPs had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was comparable to the local and national average:
• 84% of patients with diabetes on the register had their blood sugar recorded as well controlled (local average 78%, national average of 79%). The exception reporting rate for the service was 11%, local 9% and national 11%.
• 78% of patients with diabetes on the register had their cholesterol measured as well controlled (local 77%, national average 80%). The exception reporting rate for the service was 21%, local 11% and national 13%.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• All these patients had a named GP and there was a system to recall patients 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 9 January 2018

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems 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 Accident and Emergency (A&E) attendances.

• Immunisation rates were slightly below for some standard childhood immunisations.

• Patients told us, on the day of inspection, 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.

• The practice worked with midwives, health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

Updated 9 January 2018

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

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

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• The practice had a named clinical lead who was responsible for reviewing the practice’s approach for the management and care of all patients over the age of 75 years.

Updated 9 January 2018

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of this population had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours on a Saturday morning and giving patients access to the three GP alliance hubs in the area.
• 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.

Updated 9 January 2018

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

• The practice carried out advance care planning for patients living with dementia.

• 81% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, (local average 82%, national average 84%).

• The practice specifically considered the physical health needs of patients with poor mental health and dementia.

• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months (local average 85%, national average 91%). The exception reporting rate for the practice was 9%, local 8% and national 9%.

• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the last 12 months local average 85%, national average 89%. (The exception reporting rate for the practice was 15%, local 9% and national 12%).

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

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 9 January 2018

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.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice had 24 patients on the learning disability register, 100% of these patients had received a health check in the last year.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.