Market Overton and Somerby Surgeries

Updated 23 March 2017

Market Overton and Somerby Surgeries are part of a group of three GP practices which includes a GP practice located in Oakham and a branch surgery located in Somerby. Market Overton and Somerby Surgeries provides primary medical services to approximately 3,721 patients who reside in Market Overton and surrounding areas. The practice is located in purpose built premises with staff and patient car parking available and wheelchair access from the rear car park to the main entrance. The patient area is on the ground floor with suitable access for patients. The practice has an on-site dispensary and dispenses to 82% of the patient list. The practice has seen an increase of approximately 55% in the patient list size over the last seven years with a 12% increase within the last eight months. The practice provides services to a large care home for patients with learning disabilities.

It is located within the area covered by NHS East Leicestershire and Rutland Clinical Commissioning Group (CCG). It is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; maternity and midwifery services and surgical procedures.

At the time of our inspection the practice employed eight GP partners, one salaried GP, one business director, one practice manager, one nurse manager, two practice nurses, one health care assistant, two dispensary managers and four receptionists/dispensers. Not all members of staff worked solely at this practice, some members of staff also worked at other surgeries within the group for example, three GPs work mainly at Market Overton and Somerby Surgeries.

The practice is open from 8am until 6.30pm Monday to Friday. Appointments are available from 8.30am until 11am and from 2.30pm until 6pm Monday to Friday with the exception of a Thursday when appointments are available until 4.30pm. The practice also offers an open access walk in system for routine appointments on a Monday Wednesday and Thursday.

The practice has General Medical Services (GMS) contract which is a contract between the GP partners and the CCG under delegated responsibilities from NHS England.

The practice is an accredited yellow fever centre which is registered with NATHNaC (National Travel Health Network and Centre).

The practice has a higher number of patients between the ages of 40 and 79 years of age. 25% of the practice population are aged over 65 and 9% are aged over 76 years of age. 55% of patients have a long standing health condition compared to the national average of 53%.

The practice provides on-line services for patients such as to book routine appointments, ordering repeat prescriptions and access to on line summary care record.

When the practice is closed patients are able to use the NHS 111 out of hour’s service.

Updated 23 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Market Overton and Somerby Surgeries on 10 January 2017. 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 areas where the provider should make improvement are:

• Review processes in place in relation to clinical audits to ensure full cycle audits are carried out to improve patient outcomes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 March 2017

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.

• Performance for diabetes related indicators was 100% which was the maximum amount of points available compared to the CCG average of 93% and the national average of 90%. (Exception reporting rate was 6% which was lower than the CCG average of 11% and the national average of 12%).

• 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 multi-disciplinary package of care.

Updated 23 March 2017

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.

• The practice’s uptake for the cervical screening programme was 76%, which was comparable to the CCG average of 78% and the national average of 74%.

• 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.

• Childhood immunisation rates for the vaccinations given were higher than CCG/national averages for children under two year old and below average for five year olds. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 91% to 100% and five year olds from 82% to 94%.

Updated 23 March 2017

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.

• The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening.

• All housebound patients had a care plan in place which was reviewed on a regular basis.

Updated 23 March 2017

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 provided on-line services for patients such as to book routine appointments and ordering repeat prescriptions.

Updated 23 March 2017

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

• Performance for mental health related indicators was 99% whcih was higher than the CCG average of 97% and the national average of 94%. (Exception reporting rate was 29% which was lower than the CCG average of 30% and the national average of 11%).

• 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.

Updated 23 March 2017

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 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.