Archived: Circuit Lane Surgery

Updated 2 September 2016

Circuit Lane Surgery is located in the Southcote area of Reading. The premises were purpose built as a medical centre and cover two storeys. All consulting and treatment rooms are on the ground floor. There are approximately 10,300 patients registered with the practice. The age profile of the registered population is similar to the national average with slightly more patients aged between 55 and 69 than average. There are a number of patients experiencing income deprivation.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8.30am to 12pm every morning and 2.30pm to 6pm daily. Extended hours surgeries are offered on Monday and Thursday evenings between 6.30pm and 8pm and on alternate Saturday mornings between 8.30am and 11am.

When the practice is closed, out-of-hours (OOH) GP cover is provided by the Westcall OOH service. Notices on the entrance door, in the patient leaflet and on the practice website clearly inform patients of how to contact the OOH service.

Circuit Lane Surgery continues to experience a period of significant instability which has been evident since early 2015. The partnership that previously held the contract was disbanded in February 2015. NHS England offered an interim contract to maintain services for the local population. Berkshire Healthcare NHS Foundation Trust took on the temporary contract from February 2015. The permanent contract was put out to tender in early 2016 and Berkshire Healthcare NHS Foundation Trust chose not to submit a tender to continue to manage the service. The Trust has continued to manage and maintain the services until a new provider takes on the service from 1 September 2016. There has been, and continues to be, a high turnover of clinical staff since the previous partnership folded. The team of GPs and practice nurses has increased because the Trust recognised that the practice required additional clinical input.

All services are provided from; Circuit Lane Surgery, 53 Circuit Lane, Southcote, Reading, Berkshire, RG30 3AN.

Updated 2 September 2016

Letter from the Chief Inspector of General Practice

On 9 December 2015 during a comprehensive inspection of Circuit Lane Surgery we found concerns related to the following: The practice had not evaluated patient feedback in relation to the care received from clinical staff and patient feedback reported poor access to appointments at the practice. In addition we found the practice was not recording the checks of emergency equipment, had failed to dispose of an out of date controlled medicine and had not made patients aware of the availability of a chaperone service. The report setting out the findings of the inspection was published in January 2016.

Following the inspection the practice sent us an action plan detailing how they would improve on the areas of concern. We carried out an announced focused inspection of Circuit Lane Surgery on 28 July 2016 to ensure the changes the practice told us they would make had been implemented and to apply an updated rating.

We found the practice had made significant improvements since our last inspection on 9 December 2015. We have re-rated the practice overall as good. Specifically, they had made improvements to the provision of responsive provision of services although they remain rated as requires improvement for provision of caring services. The ratings for the practice have been updated to reflect our findings.

At this inspection we found:

• The controlled medicines found at the previous inspection had been appropriately destroyed. The practice was following their assessment by not holding controlled medicines on the premises.
• The chaperone service was promoted by display of posters in the waiting room and each consulting and treatment room.
• The practice held records of regular checks of the emergency equipment.
• Patient feedback in regard to accessing the practice by telephone had improved. The practice had installed a new telephone system with more incoming lines in April 2016.
• Patient feedback in regard to obtaining an appointment in a timely manner had improved. The practice had introduced a revised appointment system in February and March 2016.
• Patient feedback in regard to being treated with care and concern had improved.
• The practice had invested in customer care training to support staff in delivery of a compassionate service to patients.

However,

• Patient feedback in relation to continuity of care was not wholly positive.
• Patients continued to report problems with the issue of repeat prescriptions

The areas where the provider must make improvements are: 

• Responding to feedback from patients in regard to improving continuity of care and clinicians treating patients with care and concern.

In addition the provider should: 

• Ensure repeat prescriptions are produced efficiently and in a timely manner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 September 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.
• The practice achieved all the national targets for care of patients diagnosed with diabetes.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and were offered a structured annual review to check that 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 2 September 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.
• The cervical screening rate for the practice was 91% compared to the CCG average of 83% and national average of 82%
• Appointments were available outside of school hours and the premises were suitable for children and babies. 

Updated 2 September 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.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice employed a community nurse for the elderly who undertook care reviews at the patient’s home.
• Data showed that outcomes for patients with conditions commonly found in older patients was above CCG and national averages.

Updated 2 September 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.
• Extended hours clinics were held until 8pm on two evenings each week a Saturday morning clinic was held on alternate weeks.

• Telephone consultations were available.

Updated 2 September 2016

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

• 100% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• The practice achieved 100% of the national targets for care of patients with mental health problems.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• It 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.
• It 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 people with mental health needs and dementia.

Updated 2 September 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 carers 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.