Dr P D Cregor & Partners Also known as Bourne Galletly Medical Practice

Updated 8 December 2023

Dr A M Wright and Partners is in Bourne Lincolnshire. It is locally known as the Bourne Galletly Medical Practice and is based at:

40 North Road

Bourne

Lincs

PE10 9BT

The provider is registered with CQC to deliver the Regulated Activities: diagnostic and screening procedures, family planning, maternity and midwifery services, treatment of disease, disorder or injury and surgical procedures.

The practice is situated within the Lincolnshire Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 15,160. This is part of a contract held with NHS England.

There is a team of one managing partner and 4 GP partners (3 male and 1 female) who provide cover at the practice along with 6 salaried GPs. The GPs are supported at the practice the managing partner, 1 operations manager, 1 patient service manager, 1 finance manager along with a housekeeping team and a team of reception/administration staff. The practice has a team of 10 nurses and 5 health care support workers. The dispensary is run by 1 dispensary manager, 1 assistant dispensary manager, four dispensers, 1 prescription clerk along with 3 delivery drivers.

The GPs also employed several staff through the Additional Roles Reimbursement Scheme (ARRs). For example, 2 Musculoskeletal (MSK) practitioners, 1 Clinical Pharmacist and 3 Social Prescriber and Health and Wellbeing staff.

The practice is a dispensing practice and dispense to 33% of patients. The practice was able to offer dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy.

The practice is open between 8am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended hours clinics were available Tuesday and Thursday 6.30pm to 8pm or telephone consultations with a GP or ANP for routine appointments on Saturday mornings from 9am to midday.

The GPs can carry out a number of minor surgery procedures under the primary care surgical scheme. They have a Level 3 Operating Theatre and can offer community surgery procedures in orthopaedics and general surgery.

The practice is a training practice and trains doctors to become General Medical Practitioners and are part of the East Midlands Deanery. They currently have 3 GP registrars. (GP registrars, are fully qualified and registered doctors, e.g., they have passed out of medical school and completed their 2 years of preregistration in hospital and been admitted as fully registered doctors on to the GMC list). They are also a training practice for student nurses, general practice nurses, physiotherapists and clinical pharmacists in conjunction with local universities and training hubs.

The practice was part of a network of GP practices and were a member of South Lincolnshire and Rural Primary Care Network (PCN) and a GP federation called Allied Health South Lincolnshire (AHSL) Federation.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is 10. The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is, 97.9 % White and 0.8% Asian.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, many GP appointments had been telephone consultations.

Enhanced access is provided where late evening and weekend appointments are available.

Out-of-hours services are provided by Lincolnshire Community Health Services NHS Trust.

Updated 8 December 2023

We carried out an announced comprehensive inspection at Dr A M Wright and Partners on 30 August 2023.

Overall, the practice is rated as Outstanding with the following key question ratings:

Safe - Good

Effective – Good

Caring - Outstanding

Responsive - Outstanding

Well-led - Outstanding

Following our previous inspection on 2 December 2014, the practice was rated Good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr A M Wright and Partners on our website at www.cqc.org.uk

Why we carried out this inspection.

We carried out this comprehensive inspection in line with our inspection priorities as the practice had not been inspected since December 2014. During our inspection we reviewed our 5 key questions of safe, effective, caring, responsive and well led.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• To ensure we gathered staff feedback we used a questionnaire which was given to staff electronically via email.
• Completing remote clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements) and discussing findings with the provider.
• Reviewing patient records remotely to identify issues and clarify actions taken by the provider.
• Requesting evidence to be submitted to us electronically from the provider.
• Interviews with care homes covered by the practice.
• A site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

Our findings

We rated the practice as outstanding for providing caring services because:

• People were truly respected and valued as individuals and were empowered as partners in their care, practically and emotionally, by an exceptional and distinctive service.
• Feedback from people who used the service, those who were close to them, and stakeholders was continually positive about the way staff treated people. People thought that staff went the extra mile, and their care and support exceeded their expectations.
• Feedback from patients was consistently positive and was higher than local and national averages.
• The practice demonstrated a truly patient-centred culture and staff were committed to delivering excellent care to meet the needs of individuals.
• The practice adopted a holistic approach to caring by addressing all the needs of the patient, including their physical, mental, and emotional health, while taking social factors into consideration.
• The practice had achieved outstanding results in the national GP Patient survey and had maintained these high standards for several years and remained higher than local and national averages.
• We found numerous examples of how the practice had gone to significant efforts to support vulnerable individuals to access health and social care, and how they had worked pro-actively with other organisations to support patients.

We rated the practice as outstanding for providing responsive services because:

• The practice had achieved outstanding results in the national GP Patient survey and had maintained these high scores for several years.
• Services were tailored to meet the needs of individual people and were delivered in a way to ensure flexibility, choice and continuity of care.
• There were innovative approaches to providing integrated person-centred pathways of care that involved other service providers, particularly for people with multiple and complex needs.
• The practice had educational resources to ensure the patient population had the appropriate knowledge and understanding when accessing the surgery.
• We found that patients individual needs and preferences were central to the delivery of services.
• Facilities and premises were innovative to meet the needs of a range of people who used the service.
• Patients could access care and treatment in a timely way.
• The practice embraced social prescribing for the community to ensure patients received timely intervention when they needed it most, signposted them to services that could help them and ensured support was offered locally so the patient population could easily attend appointments.

We rated the practice as outstanding for providing a well-led service because:

• Leaders had an inspiring shared purpose and motivated staff to succeed.
• There was compassionate, inclusive and effective leadership at all levels. Leaders demonstrated the high levels of experience, capacity and capability needed to deliver high-quality, person-centred and sustainable care. There was a deeply embedded system of leadership development and succession planning, which ensured that the leadership represented the diversity of the workforce.
• Leaders at every level were visible and approachable. Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond.
• There were high levels of staff satisfaction across all staff groups. Staff were proud of the organisation as a place to work and spoke highly of the culture. Staff at all levels were actively encouraged to speak up and raise concerns, and all policies and procedures positively supported this process. There were consistently high levels of constructive staff engagement.
• Staff felt valued and supported to develop personally and professionally.
• There was a strong organisational commitment towards equality and inclusion across all the patient population and the workforce. Quality and integrity were a high priority resulting in a caring culture within a strong practice.

We have rated this practice as good for providing safe and effective services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.

Whilst we found no breaches of regulation, the areas the practice should improve are:

• Continue to monitor antibiotic prescribing.
• Implement the newly formalised system for reviewing the prescribing practice of non-medical prescribers.
• Continue to encourage uptake of childhood immunisations and cervical cancer screening.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care