Swanage Medical Practice

Updated 23 May 2016

Swanage Medical Practice is located at Station Approach, Swanage, Dorset, BH19 1HB. The practice has a patient population of approximately 11500 and is the only GP practice located in Swanage.

The practice is located in the centre of a busy seaside town. The practice population increases significantly during the summer months due to holiday makers. The practice has a predominantly older population with 53% of patients being over the age of 65. The practice has 10 GP partners and two salaried GPs. Seven GPs were male and five were female. Other practice staff includes practice nurses, a health care assistant, a practice manager and teams of administration and

reception staff. The location has ten consultation rooms and six treatment rooms. The district nursing team for the area is also based at the practice.

The practice is a research active practice with GPs involved in medical research. The premises are owned by the GP partners.

The practice is open between 8.30am and 1pm and 2pm to 6.30pm Monday to Friday. The practice offered some extended hours appointments on some Monday and Wednesday evenings and alternate Saturday mornings but the timings of these appointments were not publicised in

the practice, on the practice information leaflet or website.

During the period late July to mid September additional appointments for holidaymakers and visitors are held Monday to Friday at 1.50pm. These appointments are ‘sit and wait’ services. In addition there are ‘sit and wait’ appointments for patients registered with the practice on weekday mornings between 9am and 10.30am and weekday afternoons between 3pm and 4pm.

The practice has a personal medical services contract, which is a locally agreed alternative to the standard general medical services contract used when services are agreed locally with a practice which may include additional services beyond the standard contract. The practice GPs opted out of providing their own out of hours care and out of hours care was provided by South West Ambulance Service via the NHS 111 system.

We previously inspected Swanage Medical Practice on 26 August 2015. Following this inspection, the practice was given a rating of good. A copy of the report detailing our findings can be found at www.cqc.org.uk/ 

Updated 23 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Swanage Medical Practice on 26 August 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned for.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about treatment.

• The practice experienced a high demand for appointments, especially during the summer months and had introduced an additional temporary residents surgery to provide care for a high number of holiday makers that attended the practice.
• Only 70.9% of patients were satisfied with the practice’s opening hours compared to the Clinical Commissioning Group average of 78.8% and national average of 75.7%.

• 100% of people experiencing poor mental health had a care plan documented in their records within the last 12 months and the practice was proactive in supporting people experiencing poor mental health.

• 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.

However there were areas of practice where the provider needs to make improvements.

The areas where the provider must make improvements are:

• The cleaning cupboard used for storing cleaning products as well as keys must be secured to prevent unauthorised access.

In addition, the provider should:

• Ensure that all staff where relevant receive updated training in key areas such as infection control and health and safety.
• Continue to monitor and improve access to patient appointments and publicise the times of extended hour’s surgeries to patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 November 2015

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 two nurses had completed a diploma in diabetes care. Longer appointments and home visits were available when needed. The practice also employed a nurse who specialised in cardiac care to manage and monitor the care of patients who had a history of stroke or coronary heart disease. All these patients had a named GP and a structured annual review to check that their health and medicine needs were being met. For those people with the most complex needs, named GPs and nurses worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 26 November 2015

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. Immunisation rates were comparable with national averages for children under the age of two. However, data available at the time of our visit indicated that immunisation rates for children under the age of five were low in comparison to the national average. Staff followed up on children who did not attend for 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. Appointments were available outside of school hours and the premises were suitable for children and babies. Multi-disciplinary team meetings were held with health visitors and social services.

Updated 26 November 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people and offered health checks for patients over the age of 75. It was responsive to the needs of older people, and offered home visits, care home visits and rapid access appointments for those who needed them. Multi-disciplinary team meetings were held to discuss the care of older patients and these were attended by community matrons, physiotherapists from the reablement team, district nurses and practice nurses.

Updated 26 November 2015

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 offered evening appointments and some appointments on a Saturday morning but this service was not well advertised. 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.

Updated 26 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All patients on the mental health register held by the practice had a care plan documented in their records within the last 12 months. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia and supported patients to access support organisations and voluntary organisations. A counselling service was available within the practice. GPs reviewed medicines for patients experiencing poor mental health, prescribing on a weekly basis if required. The practice ran a weekly report to identify patients who had been diagnosed with depression and checked their records to see when they were next due a review.

Updated 26 November 2015

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 those with a learning disability. The practice offered a directed enhanced service to patients with learning disabilities and had carried out annual health checks for patients with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.