Kingswood Surgery

Background to this inspection

Updated 15 June 2017

Kingswood Surgery is a GP practice located in Totteridge in High Wycombe, Buckinghamshire. Kingswood Surgery is one of the practices within Chiltern Clinical Commissioning Group (CCG) and provides general medical services to approximately 10,300 registered patients. A CCG is a group of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

All services are provided from:

Kingswood Surgery, Hollis Road, Totteridge, High Wycombe, Buckinghamshire HP13 7UN.

According to data from the Office for National Statistics, Buckinghamshire has mid to high levels of affluence, low incidence of substance misuse and severe mental health problems. However, the Kingswood Surgery is located within a pocket of deprivation.

Ethnicity based on demographics collected in the 2011 census shows there is ethnic diversity within the population of Totteridge and the surrounding area. Approximately 20% of the population is composed of people with an Asian background and 7% of people with a black background. In addition, Totteridge has a growing Eastern European community; this is reflected in the patient population list, as there are a growing number of Polish patients registered with Kingwood Surgery. The ethnic diversity within the population creates a transient patient population; patients are often outside of the country for long periods, which has an impact on screening and recall programmes.

The age of the practice population is largely similar when compared to the national averages; however there are a higher proportion of children aged below nine years of age registered at the practice. The prevalence of patients with a long standing health condition is 46% compared to the local CCG average of 52% and national average of 54%. Kingswood Surgery also provides primary care GP services for a local care home for adults with complex learning disabilities (approximately five patients).

The practice comprises of three GP Partners (two female and one male) who are supported by four salaried GPs and two long term locum GPs. There is a clinical pharmacist working at the practice. The all-female nursing team is led by a nurse manager who is also a prescribing nurse practitioner and the team consists of three practice nurses and a health care assistant. The current practice manager commenced employment with the practice in December 2016 which was after the comprehensive inspection in November 2016. A team of reception, administrative and secretarial staff support the GPs and practice manager undertake the day to day management and running of Kingswood Surgery.

Kingswood Surgery is open between 8am and 6.30pm Monday to Friday (appointments between 8am and 5.30pm). Each week extended hours for pre-bookable appointments were available every Thursday and Friday morning between 7am and 8am, and every Tuesday evening between 6.30pm and 8pm.

The practice has opted out of providing the out-of-hours service. This service is provided by the out-of-hours service accessed via the NHS 111 service. Advice on how to access the out-of-hours service is clearly displayed on the practice website, on both practices door and over the telephone when the surgery is closed.

Overall inspection

Good

Updated 15 June 2017

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at Kingswood Surgery in High Wycombe, Buckinghamshire on 18 and 22 November 2016 found breaches of regulations relating to the effective, responsive and well-led delivery of services. The overall rating for the practice was requires improvement. Specifically, we found the practice to require improvement for the provision of effective, responsive and well led services. The practice was rated good for providing safe and caring services. The concerns identified as requiring improvement affected all patients and all population groups were also rated as requires improvement. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Kingswood Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 23 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in November 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the practice had made improvements since our last inspection. At our inspection on the 23 May 2017 we found the practice was meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the practice is now rated as good. All six population groups have also been re-rated following these improvements and are also rated as good.

Our key findings were as follows:

There was now an overarching governance framework which supported the delivery of the good quality care. Improvements had been made to deliver significant progress in improving services.

The practice had established and was now operating safe and effective systems to assess, manage and mitigate the risks identified relating to fire safety.

Systems were in now place to identify and record all feedback from patients. This included a further review of the outcomes of the national GP patient survey to determine appropriate action with a view to improving the patient experience. Furthermore, feedback from patients through a newly reinstated patient participation group (PPG) was sought and acted upon.

The practice had implemented a clinical audit schedule with the view to increase the level of clinical audit activity, ensuring quality improvement.

Appropriate appraisal arrangements were now in place, appraisals had been completed and there was evidence of performance monitoring and identification of personal and professional development.

The practice had taken steps to improve rates of practice patients attending national cancer screening programmes.

Information leaflets were now available in languages consistent with the variety of cultures in High Wycombe.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice