• Doctor
  • GP practice

Elm Tree Surgery

Overall: Good read more about inspection ratings

High Street, Shrivenham, Swindon, Wiltshire, SN6 8AG (01793) 782207

Provided and run by:
Elm Tree Surgery

Latest inspection summary

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Background to this inspection

Updated 19 March 2019

The provider, Elm Tree Surgery, delivers regulated activities from its sole site at:

Elm Tree Surgery

High Street

Shrivenham

Swindon

SN6 8AG

Tel: 01793 782207

Website: www.elmtreesurgery.co.uk

Elm Tree Surgery is located in a listed building in the village of Shrivenham, Oxfordshire, and is one of 24 practices serving the NHS Swindon Clinical Commissioning Group (CCG) area. The practice premises were not originally designed to deliver primary health care services and therefore extending the premises and opportunities to make changes to the outside of the building are limited.

The practice has around 7,127 registered patients from an area surrounding the practice. Patient turnover is high (compared to other practices in Swindon CCG) because families of military staff at the nearby Defence Academy register with the practice and move on in a relatively short period of time. The number of female patients aged between 45 and 60 years is higher than the national average. There are also more patients in the 0 to 4, 5 to 9 and 70 to 74 age ranges when compared with local and national data. Many of the military staff attending the Defence Academy are from overseas and the practice has patients registered whose first language is not English. Patients of the practice speak around 60 different languages.

Over half of the registered patients live in rural locations. Patients reside in three counties – Oxfordshire, Berkshire and Wiltshire – requiring the practice to deal with three different local authorities and a variety of health care providers. Ninety-six percent of the practice population describes itself as white, and around 4% as having a Black, Asian and Minority Ethnic (BAME) background. The practice boundary has an estimated low level of socio-economic deprivation: a local area measure recorded a score of 10, on a scale of 1-10, with a higher score indicating a less deprived area. (Note that the circumstances and lifestyles of the people living in an area affect its deprivation score. Not everyone living in a deprived area is deprived and not all deprived people live in deprived areas).

Elm Tree Surgery is working with a number of other NHS GP practices locally, as part of the Brunel Health Group. The aim of the working relationship is to develop services, share best practice and collaborate on health initiatives.

The practice has a General Medical Services (GMS) contract to deliver health care services. (A GMS contract is a contract between NHS England and general practices for delivering general medical services, and is the most common form of GP contract).

Elm Tree Surgery is a research practice and offers patients the opportunity to be part of trials that address common health issues (for example, concerning mental health conditions). The surgery also offers training to qualified doctors who are seeking to become GPs.

Elm Tree Surgery is registered to provide the following regulated activities:

  • Treatment of disease, disorder or injury
  • Diagnostic and screening procedures
  • Maternity and midwifery services
  • Surgical procedures
  • Family Planning

There are four GP partners (two female, two male), and one salaried GP (female). The nursing team includes three practice nurses, and a healthcare assistant. Clinical staff are supported by a practice manager and a team of administration and reception staff. There is a dispensary at the practice which dispenses to approximately 3,400 of the registered patients. The practice also has a travel clinic and is a yellow fever centre.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments with GPs are from 8.30am to 11.30am every morning and from 2pm to 6pm. Extended hours surgeries are offered three evenings a week (various), until 7.45pm.

The practice has opted out of providing Out-Of-Hours services to its own patients. Outside of normal practice hours, patients can access the NHS 111 service, and an Out-Of-Hours GP is available at Swindon Walk-In Centre. Information about the Out-Of-Hours service was available on the practice website, in the patient registration pack, and as an answerphone message.

Overall inspection

Good

Updated 19 March 2019

We carried out an announced comprehensive inspection at Elm Tree Surgery on 26 February 2019, as part of our inspection programme. The service was previously inspected on 23 June 2016, and rated Good overall.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

This means that:

  • Patients had good outcomes because they received effective care and treatment that met their needs.
  • Patients were supported, treated with dignity and respect and were involved as partners in their care.
  • People’s needs were met by the way in which services were organised and delivered.
  • The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.
  • Patients could access appointments and services in a way and at a time that suited them. Routine appointments were available within two working days, urgent appointments were offered on the same day and extended hours surgeries ran on three evenings every week.
  • The practice was significantly (around 21 percentage points) above local and national averages for patient satisfaction, across a range of indicators. For example, access to services, and satisfaction with the type of appointment offered.
  • The practice is involved with and supports a number of initiatives to improve diabetic health outcomes. For example:
    • A local support group for diabetic patients was developed by a practice nurse. The group is now led by diabetic patients and their families. Meetings are attended by around 20 people, and the group meets six times per year. Guest speakers have addressed cholesterol checks, glucose monitoring, and other relevant subjects.
    • A practice nurse set up and ran a diabetic education discussion group and developed a diabetes care handbook. The handbook has been adopted by the local clinical commissioning group, for use by other practices in the Swindon area.

We found areas where the provider should make improvements. The provider should:

  • Continue to identify carers to enable this group of patients to access the care and support they require.
  • Continue efforts to improve rates for childhood immunisations.
  • Continue efforts to increase the programme coverage of women eligible to be screened for cervical cancer.
  • Review arrangements for medicines storage and security, in areas accessed by contract staff. The practice building was secure and prescriptions could be easily tracked. However, the practice's assurance processes did not include its own checks for contract staff accessing the premises.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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