Background to this inspection
Updated
6 June 2018
Harambee Surgery is situated at 27 Skipton Road in Trawden on the outskirts of Colne at BB8 8QU and is part of the NHS East Lancashire Clinical Commissioning Group (CCG). Services are provided under a general medical service (GMS) contract with NHS England.
The surgery is housed in two-storey purpose-built accommodation with all patient services on the ground floor and offers access and facilities for wheelchair users and visitors. The practice website can be found at http:
There are approximately 4,133 registered patients. The practice population includes a higher number of patients aged between 40 and 70 years of age than the national average; 45% compared to 37% nationally.
Information published by Public Health England, rates the level of deprivation within the practice population group as seven on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male and female life expectancy in the practice geographical
area is higher the national average at 82 years for males, compared to 80 years nationally and 84 years for females, compared to 83 years nationally.
The practice is able to offer dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. Practice opening hours are from 8am to 6.30pm Monday to Friday and extended hours appointments are offered on Monday and Thursday mornings from 7.30am to 8am and on Monday and Wednesday evenings from 6.30pm to 7.10pm. Appointments with GPs at the practice are from 9am to 11.30am and 3.30pm to 6pm. The practice dispensary opens at 8.30am and is closed from 1pm to 2pm on weekdays except for Thursdays when it closes at 12.30pm. When the practice is closed, patients are able to access out of hours services by telephoning NHS 111.
There are three GPs, one male and two female, one advanced nurse practitioner, one assistant practitioner, one phlebotomist and three staff who dispense prescriptions including a dispensary supervisor. These are supported by a practice manager and an experienced team of reception/administration staff. At the time of our inspection, one of the GPs was on maternity leave and the practice used regular locum GPs to cover this absence. The practice has been a training practice since 1997 and is currently training FY2 doctors. These are trainee doctors in their 2nd year of foundation training and at the time of our inspection a new FY2 doctor was to start in the following week.
The practice provides family planning, surgical procedures, maternity and midwifery services, treatment of disease, disorder or injury and diagnostic and screening procedures as their regulated activities.
Updated
6 June 2018
This practice is rated as Good overall.
(Harambee Surgery is a new registered practice and this is the first inspection of this service under this provider.)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Outstanding
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Harambee Surgery on 4 April 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- Safety systems were comprehensive and actions were taken to prevent legionella occurring in the water system (legionella is a term for a particular bacterium which can contaminate water systems in buildings). However, there was no evidence of the original risk assessment for this.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured care and treatment was delivered according to evidence- based guidelines.
- Clinicians had access to appropriate information to deliver safe care and treatment. We saw that some staff were removing some items of post without the GP having had sight of them and without a protocol for this or audit of the process. We saw that these items were few and of minor clinical importance and the practice said they would address this.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported they were able to access care when they needed it. Patient feedback on the care and treatment delivered by all staff was overwhelmingly positive.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw areas of outstanding practice:
- The practice had appointed staff to champion and support the care certain patient groups received. They had appointed a patient dementia champion who consulted with patients and their carers to improve the practice premises; changing fixtures and fittings to become more dementia-friendly. Another staff member was appointed compassion champion who worked closely with children and vulnerable patients visiting the practice. We saw many examples of feedback from children and parents to say how much they valued this input and that their visit to the practice was a positive experience because of it.
- The practice had worked with patients who attended the local accident and emergency (A&E) department to try to ensure that all such attendances were appropriate. We saw evidence of reducing patient attendances at A&E over a period of nineteen months up to the time of our inspection.
The areas where the provider should make improvements are:
- Continue to develop a workflow protocol to deal with communications coming into the practice and an audit process to ensure compliance.
- Following the new legionella risk assessment to be carried out, confirm that the mitigating actions currently being completed are appropriate.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice