The Bassingham Surgery

Updated 23 March 2017

The Bassingham Surgery provides primary medical services to approximately 6,038 patients and is situated in a rural village in Lincolnshire. The practice is located in a purpose built health centre built in 2005 and has adequate patient and staff car parking including disabled parking bays. All clinical areas are located on the ground floor and are accessible to patients with disabilities and those who use wheelchairs. The practice has an on-site dispensary and dispenses to approximately 97% of the patient list. The practice is a member of the dispensing services quality scheme (DSQS).

The practice provides services to patients who reside in three care homes for patients with learning disabilities, challenging behaviour and dementia in the surrounding area.

It is located within the area covered by NHS Lincolnshire West Clinical Commissioning Group (LWCCG). 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; family planning.

The practice is a training practice for year five medical students who are enrolled with the University of Nottingham.

At the time of our inspection, the practice employed two GP partners, one salaried GP, one nurse practitioner, three practice nurses, two health care assistants/phlebotomists, one practice secretary, one administration manager, one senior dispenser and a team of 11 receptionists/dispensers. All staff were supported by a practice manager.

The practice is open from 8am until 6.30pm Monday to Friday. Appointments are available between these times. The practice offers extended hours appointments on a Monday each week until 8pm.

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 part of a Federation of practices called South Lincoln Healthcare within NHS Lincolnshire West Clinical Commissioning Group (LWCCG).

48% of the patient population suffer with a long standing health condition which is lower than the CCG average of 55% and the national average of 53%. 21% of patients are under the age of 21 and 16% of patients are 65 years of age and over.

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

When the surgery is closed GP out-of-hours services are provided by provided by Lincolnshire Community Health Services NHS Trust which can be contacted via NHS111.

Updated 23 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Bassingham Surgery on 5 October 2016. 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.

• Results from the national GP patient survey showed patients responded positively to questions about their involvement in planning and making decisions about their care and treatment. Results were higher than local and national averages.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• A nurse responder worked directly with patients who suffered with a long term health condition both in-house and in the community to improve their level of care and to help reduce unplanned admissions to hospital.

• 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.

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.

• A nurse responder worked directly with patients who suffered with a long term health condition both in-house and in the community to improve their level of care and to help reduce unplanned admissions to hospital.

• Performance for diabetes related indicators was 93% which was higher than the CCG average of 91% and the national average of 90%. (Exception reporting rate was 11% which was comparable to the CCG average of 10% 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.

• The practice’s uptake for the cervical screening programme was 91%, which was higher than the CCG average of 80% and the national average of 74%.

• 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.

• Childhood immunisation rates for the vaccinations given were higher than CCG/national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 96% to 100% and five year olds ranged from 92% to 96%.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice held midwifery led clinics twice weekly.

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 also encouraged its patients to attend national screening programmes for bowel and breast cancer screening. For example, 79% of female patient aged 50-70 years of age had attended for breast cancer screening within six months of invitation months compared to the CCG average of 78% and the national average of 73%.

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 offered extended hours appointments on a Monday each week until 8pm with GPs and nurses.

• The practice offered in-house physiotherapy clinics on a weekly basis.

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 100% which was the maximum amount of points available compared to the CCG average of 92% and the national average of 93%. Exception reporting rate was 3% which was lower than the CCG average of 15% 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.