Ringwood Medical Practice at Ringwood Medical Centre

Updated 15 August 2016

Dr S Thompson & Partners, also known as Ringwood Medical Centre, is located in a purpose built building at The Close, Ringwood, Hampshire, BH24 1JY. The practice is based near the town centre of Ringwood, a busy market town on the edge of The New Forest. The practice has approximately 11,200 registered patients.

The practice provides services under a NHS General Medical Services contract and is part of NHS West Hampshire Clinical Commissioning Group (CCG). The practice is based in an area of low deprivation compared to the national average for England. A total of 28% of patients at the practice are over 65 years of age, which is higher than the CCG average of 22% and national average of 17%. A total of 59% of patients at the practice have a long-standing health condition, which is slightly higher than the CCG average of 55% and national average of 54%. Less than 1% of the practice population describe themselves as being from an ethnic minority group; the majority of the population are White British.

The practice has five GP partners, three of whom are female and two who are male, as well as employing two male salaried GPs. Together the GPs provide care equivalent to approximately 43 sessions per week. The GPs are supported by four practice nurses and three health care assistants who provide a range of treatments and are equivalent to just under five whole time equivalent nurses. The practice also employs two phlebotomists. The clinical team are supported by a management team with secretarial and administrative staff. The practice is a training practice for doctors training to be GPs (registrars) and a teaching practice for medical students.

Dr S Thompson and Partners is open between 8am and 6.30pm Monday to Friday. Extended hours surgeries are available every Monday morning from 7.30am, and every Monday evening until 7pm or 7.45pm, alternate Saturdays from 8am to 12pm.. Appointments with a GP are available until 11.30 am and again from 2.30pm until 6pm daily. The GPs also offer home visits to patients who need them. Care to patients is provided on the first floor of a purpose built building. The practice has a lift to support patients who are unable to manage stairs.

The practice has opted out of providing out-of-hours services to their own patients and refers them to the Portsmouth Healthcare service via the NHS 111 service. The practice offers online facilities for booking of appointments and for requesting prescriptions.

We visited Dr S Thompson and Partners as part of this inspection, which has not previously been inspected by the Care Quality Commission.

Updated 15 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr S Thompson & Partners on 5 July 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 been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent 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.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice had adopted a campaign to promote more compassionate care in the NHS. The campaign focussed upon ensuring that staff introduced themselves and their role to patients. Patients told us that they were pleased the practice were supporting this campaign.

We saw an area of outstanding practice:

• The Patient Participation Group reviewed anonymised complaints from patients to deliver a patient perspective and enhance any learning from complaints.

However, the areas where the provider should make improvement are:

• Review the patient feedback regarding the difficulties in making an appointment by telephone.
• Review the responses to complaints to ensure they are consistently in line with recommended guidance.
• Review the process for identifying carers so appropriate support can be given to this population group.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 August 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.
• 74% of patients with diabetes had an acceptable blood pressure reading in 2014-2015 compared to a CCG average of 77% and national average of 78%.
• Longer appointments and home visits were available when needed.

All these patients had a named GP and 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 15 August 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. There was a system in place to follow up children who did not attend for 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.
• 88% of eligible women received a cervical smear in the preceding 5 years, which is better than the national average of 82%.
• The practice offered information to children in suitable formats to support them to give feedback about the practice.
• 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.

Updated 15 August 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.
• Performance for conditions common in older patients was better than national averages. For example, 92% of patients with high blood pressure had a last blood pressure reading which was within acceptable limits, compared to the national average of 83%.

Updated 15 August 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 online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 15 August 2016

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

• 99% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is better than the national average of 84%.
• 97% of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months, which is better than the national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice 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.
• 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. The practice had been awarded ‘dementia friendly’ status in April 2016.

Updated 15 August 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 homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice had identified 87 patients with a learning disability. 90% of these patients had received a physical health check in the previous 12 months.
• The practice had undergone specific training to help them support patients with learning disabilities.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.