Drs Sells and Dr Kyaw Also known as Lyngford Park Surgery

Updated 2 July 2015

Dr Burton, Dr Sells, Dr Edwards, Dr Shackleton, Lyngford Park Surgery, Fletcher Close, Taunton, Somerset. TA2 8SQ is located close to the centre of Taunton. The premises were purpose built in 1986. The practice has approximately 5,770 registered patients, this figure is growing monthly. The practice accepts patients from an area in the northern parishes of Taunton and surrounding villages.

There are four GPs and a team of clinical staff including practice nurses and a health care assistant. Two GPs are female and two are male, the hours contracted by GPs are equal to 3.1 whole time equivalent employees. Collectively the GPs provide 28 patient sessions each week. Additionally the three nurses employed equal to 1.06 whole time equivalent employees and a health care assistant equal to 0.56 whole time equivalent employees employed. Non-clinical staff included secretaries, support staff and a small management team including a practice manager and deputy practice manager. The practice is a registered training practice with the Severn Deanery and supported a Registrar GP and a foundation programme (F2) doctor at the time of our inspection.

The practice population ethnic profile is predominantly White British with an age distribution of male and female patients’ equivalent to national average figures. There are about 4% of patients from other ethnic groups, the majority being patients from Poland The average male life expectancy for the practice area is 74 years compared to the Taunton average of 79, across the Somerset Clinical Commissioning Group area the female life expectancy is 84 years. The practice population has a particularly high incidence of cancer with 81 diagnosed cases compared to an expected value of 41. Similarly there is a particularly high incidence of chronic obstructive pulmonary disease (COPD) with 120 diagnosed patients compared to an expected number of 90. There is also a high proportion of adults registered with the practice who smoke (24%) compared to the Taunton average of 15%. Services are available to support patients in the groups mentioned.

The National GP Patient Survey published in January 2015 indicated just over 90% of patients said they would recommend the practice to someone new to the area. This was above the Somerset Clinical Commissioning Group average of 83%. Local Public Health statistics (January 2014) demonstrate that Lyngford Park Surgery has a high level of social deprivation, the Index of Multiple Deprivation being 23.2 in compared to a Somerset average of 16.9. Approximately 49% of the practices population live in the 20% most deprived neighbourhoods in Somerset.

The practice has a General Medical Services (GMS) contract to deliver health care services; the contract includes enhanced services such as extended opening hours, childhood vaccination and immunisation scheme, facilitating timely diagnosis and support for people with dementia and minor surgery services. It also provides an influenza and pneumococcal immunisations enhanced service. These contracts act as the basis for arrangements between the NHS Commissioning Board and providers of general medical services in England.

The practice has opted out of providing out-of-hours services to their own patients. This service is provided by South Western Ambulance Service NHS Foundation Trust and patients are directed to this service by the practice during out of hours.

Updated 2 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lyngford Park Surgery on 27 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for older patients, patients with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Health promotion and prevention was a priority for the practice.
• Patients said they were treated with compassion, dignity and respect by all staff 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 a named GP and that there was continuity of care, with urgent and triage 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.

We saw areas of outstanding practice:

• We saw evidence of the practice providing health promotion in the community. For example, the registered manager partner provided a “When things go wrong below the belt” talk to approximately 30 men about testicular cancer, erectile dysfunction and prostate problems. Practice staff attended a local ‘Fun Day’ and ‘pamper’ evening and provided blood pressure checks and blood oxygen saturation checks using pulse oximeters to people attending the events. The GPs also provide brief medical articles for parish magazines in support of health promotion; recent articles included information about; hay fever; chronic pain and seasonal diabetes advice.
• The practice had implemented a “Year of Care” approach for diabetic patients. Patients are given test results in advance of their appointment with the lead diabetic nurse which gave them time to think about their progress before their care planning appointment and enabled them to be more involved in their care and treatment.

However there were areas of practice where the provider could make improvements.

Importantly the provider should;

• Ensure all staff are clear about when to obtain written consent and how to record it.
• Review systems for recording training to ensure all staff records are up to date.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 July 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 2 July 2015

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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 2 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 2 July 2015

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. The practice had previously offered NHS Health Checks to all its patients aged 40 to 75 years, this was now a contracted out service in the Somerset area.

Updated 2 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 100% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 2 July 2015

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. It had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up. It offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.