Saxon Cross Surgery

Updated 12 April 2018

Saxon Cross Surgery is located within Stapleford Care Centre in a residential area in Nottinghamshire. It provides primary medical services to its 7,301 registered patients, commissioned by NHS England and NHS Nottingham West CCG. The practice is situated on the upper ground floor of the care centre building and is co-located with a range of community based services and another GP practice.

Public Health England data shows there are a higher proportion of children under 5 years of age, and a slightly higher percentage of older people on the patient list compared with other practices in England. The majority of patients are of white British background.

The practice has five GP partners (three male and two female) and one salaried GP. It is a training practice for GP Registrars who work at the practice. A GP Registrar is a qualified doctor who is training to become a GP through a period of working and training in a practice. They usually spend at least two years working in a hospital setting before joining a GP practice and are closely supervised by a senior GP as their trainer. The practice has an advanced nurse practitioner (this is a highly skilled qualified nurse with greater autonomy to see patients and make decisions without the GP’s input) and four part-time practice nurses, two of whom are prescribers. The clinical team are supported by a full time practice manager, a health care assistant and reception and administration staff.

The practice is open between 8am- 6.30pm from Monday to Friday. Extended opening hours are offered every Tuesday from 6.30pm to 8.30pm with two GPs available. Appointments are available from 8.05am to 5.50pm, with emergency appointments added at the end of clinics. An out-of-hours service is provided for patients by Nottingham Emergency Medical Services (NEMS) via the 111 service.

The practice offers a range of enhanced services (that is services provided above those included within their core contract) including minor surgery.

Updated 12 April 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Outstanding overall. (Previous inspection 29/09/2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Outstanding

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Outstanding

People with long-term conditions – Outstanding

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced inspection at Saxon Cross Surgery on 14 November 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• At our last inspection, we found that a GP partner had led on the implementation of eHealthscope, a shared intranet system across the local CCG to facilitate learning by the sharing of data and access to a range of documents including best practice guidance. This innovation had led to eHealthscope being rolled out to all practices across Nottinghamshire. At this inspection, we found the practice had continued to develop this system to review and improve patient care by creating information sharing platforms with other practices and healthcare providers.

• The practice used information about care and treatment to make improvements. For example, they initiated opportunistic pulse rhythm checks to improve their identification of people with atrial fibrillation, resulting in 78% of eligible people having checks for the condition and two people being diagnosed with the condition.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Staff had the skills, knowledge and experience to carry out their roles. Mentorship of the nursing staff was shared amongst all GPs in the practice, enabling them to learn different skills from the clinicians.

• The practice understood the needs of its population and tailored services in response to those needs. Patients were able to access care and treatment from the practice within an acceptable timescale for their needs through a variety of methods.

• There was a strong focus on continuous learning and improvement at all levels of the organisation. This included the sharing of policies, significant events and clinical audits with other practices within the CCG using the shared eHealthscope system and practice group meetings. As a result, some practices implemented the audits and adopted the same approach to improving the quality of care across the whole CCG.

We saw some areas of outstanding practice:

• The practice continued to promote innovation by developing a workflow system within the eHealthscope which enabled holistic care of registered patients with complex needs by identifying community teams that were involved or needed to be involved in their care.

• Clinicians initiated opportunistic pulse rhythm checks to improve their identification of people with atrial fibrillation, resulting in 78% of eligible people over 64 years old having checks for the condition and two people being diagnosed with the condition.

• Leaders at all levels were visible within the practice as well as the CCG where they held various positions, enabling them to influence improvements across the group of practices. Mentorship for the nursing team was rotated amongst all the GP partners to share skills and build resilience within the team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 April 2018

Updated 12 April 2018

Updated 12 April 2018

Updated 12 April 2018

Updated 12 April 2018

Updated 12 April 2018