Haresfield House Surgery

Updated 19 March 2019

Haresfield House Surgery is on the edge of Worcester city. The practice has a branch surgery in Kempsey and so has a mixed city and rural catchment area. The Kempsey site includes a dispensary for practice patients who live over one mile (1.6km) from the surgery. As part of the inspection we visited both sites.

The practice primarily covers an area with good levels of employment. The practice has good transport links and the main surgery is in purpose built premises which also accommodates another GP practice and a pharmacy.

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

Haresfield House Surgery is situated within the South Worcestershire Clinical Commissioning Group (CCG) and provides services to 16,459 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

Parking is available on-site and a chaperone service is available for patients who request the service. This is advertised throughout the practice.

The practice has seven GP partners (three male and four female) and four salaried GPs (a mixture of male and female), two GP retainers and two GP trainees, a clinical pharmacist, one advanced nurse practitioner, five practice nurses, an assistant practitioner and a health care assistant. The clinical team is supported by a practice manager and a team of administrative, reception and dispensary staff.

The practice is a research and training practice and regularly hosts GP registrars and medical students from Birmingham University.

There are higher than average number of patients between the ages of 15-44. The National General Practice Profile states that 92% of the practice population is from a white background with a further 8% of the population originating from black, Asian, mixed or other non-white ethnic groups. Information published by Public Health England, rates the level of deprivation within the practice population group as six, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice is open between 8am and 6.30pm Monday to Friday with extended hours on Mondays 7.15am until 8am and 6.30pm until 8pm and Tuesday and Thursdays 7.15am until 8am. Home visits are available for patients who are too ill to attend the practice for appointments.

The practice does not provide out of hours services to their own patients. When the practice is closed patients are directed to contact Care UK via NHS 111.

The practice website can be viewed at: www.haresfieldsurgery.co.uk  

Updated 19 March 2019

We carried out an announced comprehensive inspection at Haresfield Medical Practice on 31 January 2019 as part of our inspection programme.

At the last inspection in June 2015 we rated the practice as good overall with outstanding for responsive.

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.

We have rated this practice as good overall and outstanding for Well-led and the population group of long term conditions because:

• The practice offered a range of comprehensive services to support and manage long term conditions. In in addition to these reviews the practice monitored patients with neurological and osteoporosis conditions.
• The practice had upskilled staff in diabetes, leg ulcers and respiratory conditions and offered specialist clinics which included multiple sclerosis reviews and bronchiectasis.
• The practice coordinated a wellbeing clinic for the review of long terms conditions for patients and their carers. This took place annually during the patient’s birth month. A bespoke appointment was set up dependant on their health needs. Multiple conditions were reviewed in one appointment and were coordinated with clinicians in the practice. All patients who were identified as a carer were invited to a wellbeing clinic review.

We have rated this practice as outstanding for Well-led services because:

• The practice used information technology to support them to manage capacity and performance. The practice had developed a protocol and  system to help them manage GP availability and appointments in a planned way. Monthly audits were carried out around clinical capacity and the demand for appointments which reduced the need for patients to be seen in the sit and wait overflow appointments. The National Survey results for 2018 could evidence that the practice was higher than local and national averages in the type of appointment patients were offered.
• The practice completed an access survey data during a twelve month period and this data was used to support the appointment access system, as well as determine the growth in patient population and clinical capacity. This supported the practice in the recruitment of more GPs to give extra access to patients due to the increase in demand.

The practice had been rated as outstanding for responsive at the last inspection in 2015. It was rated as good on this inspection because:

• The practice were previously involved in a number of initiatives such as The X-Pert Diabetes Programme and providing cover for Worcester intermediate care unit, however a number of these services had stopped and were now being carried out externally.

We also rated the practice as good for providing, safe, effective, caring and responsive services because:

• The practice demonstrated a strong leadership team with clear roles, responsibilities and lead areas and values. The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
• The practice continued to use information technology to support them in the sustainability and succession planning of the practice, for example the use of a dashboard and the matching of GP availability and appointments.
• There were clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.
• The practice worked proactively with other organisations to ensure patients had access to a range of services to support their health and wellbeing.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
• The practice worked proactively with the Patient Participation Group (PPG) to undertake a number of surveys and responded to patients’ need.
• The practice had a strong culture of learning and development. It regularly hosted medical students from a number of universities and was part of the research network. It regularly encouraged staff to undertake further learning and training to increase the skill mix within the practice and embedded this time in their working week.

Whilst we found no breaches of regulations, the provider should:

• Develop a process to ensure that controlled drugs are removed for destruction in a timely way.

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

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 19 March 2019

Updated 19 March 2019

Updated 19 March 2019

Updated 19 March 2019

Updated 19 March 2019

Updated 19 March 2019