Archived: Husbands Bosworth Surgery

Updated 17 November 2016

Husbands Bosworth Surgery is part of The Market Harborough and Bosworth Partnership. It is a GP practice which provides a range of primary medical services to around 3,529 patients. The practice dispenses medicines to patients living more than 1.6km from a pharmacy.

The practice’s services are commissioned by East Leicestershire and Rutland Clinical Commissioning Group (CCG). The practice has a General Medical Services Contract (GMS). The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

At the Husbands Bosworth Surgery the service is provided by two GP partners (male), two salaried GPs (female), one practice supervisor, two nurses, three dispensers, two health care assistants and one phlebotomist, one team leader, four receptionists and a diabetes nurse specialist. Local community health teams support the GPs in provision of maternity and health visitor services.

The Market Harborough and Bosworth Partnership is a General Practice Partnership open to all patients living within the boundaries of Market Harborough Medical Centre and Husbands Bosworth Surgery. It has three locations registered with the Care Quality Commission (CQC).

Market Harborough Medical Centre, 67, Coventry Road, Market Harborough, Leicestershire, LE16 9BX.

Husbands Bosworth Surgery, Kilworth Road, Husbands Bosworth,LE17 6JZ. Branch surgery - Welford Surgery , Village Hall, West Street, Welford, Northamptonshire, NN6 6HU

Minor Injuries Unit, Market Harborough and District Hospital, 58, Coventry Road, Market Harborough, Leicestershire, LE16 9DD.

The location we inspected on 4 October 2016 was Husbands Bosworth Surgery, Kilworth Road, Husbands Bosworth,LE17 6JZ.

Husbands Bosworth surgery was open between 8.00am and 6.30pm. The dispensary was open 8.15am to 1.00pm and 1.30pm to 6.00pm. The practice offered a range of GP and nurse appointments. Extended hours were on a Monday evening from 6.30pm to 8.30pm at the Market Harborough Medical Centre. These appointments were for working patients who could not attend during normal opening hours.

We also visited the satellite clinic held at the Village Hall, West Street, Welford, Northamptonshire, NN6 6HU. It is rented from the local council. It had parking at the side of the building. Appointments were available between 9am to 12 o’clock on a Tuesday and Thursday.

The practice has opted out of the requirement to provide GP consultations when the surgery is closed. The out-of-hours service is provided for Leicester City, Leicestershire and Rutland by Northern Doctors Urgent Care Ltd and the 111 service is provided by Derbyshire Health United. There were arrangements in place for services to be provided when the practice is closed and these are displayed on the practice website.

Updated 17 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Husbands Bosworth Surgery on 4 October 2016. Overall the practice is now rated as Good.

The purpose of this inspection was to ensure that sufficient improvement had been made following the practice being placed in to special measures as a result of the findings at our inspection on 28 January 2016 when we found the practice to be inadequate overall.

At this most recent inspection we found that extensive improvements had been made and specifically, the ratings for providing a safe and well led service had improved from being inadequate to good. The rating for providing an effective, caring and responsive service had improved from requiring improvement to good.

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

• The practice had a governance framework in place with systems and processes in place to support the delivery of their strategy.

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The practice had put an effective system in place to safeguard adults and children from abuse.
• Overall risks to patients were assessed and well managed.
• The leadership and systems and processes for the dispensary had been reviewed.
• The system in place for palliative care monitoring and review had been reviewed and new processes put in place.
• The practice now had a quality improvement programme in place which included a rolling programme for clinical audit cycles.
• 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.
• CQC comments cards were reviewed told us that patients were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• 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.

The areas where the provider should make improvement are:-

• Ensure that all necessary emergency medicines and equipment are available and suitable for use at all times.

• Increase the testing of fire alarm and legionella temperature control monitoring to a monthly basis as per recognised national guidance.

• When reviewing policies and procedures, add review date and document and amendments made.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 November 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.

• GPs had specialist interests in Rheumatology, Dermatology, Ear Nose and Throat and Ophthalmology.

• The practice had an effective system in place for quality improvement, including clinical audit.

• The percentage of patients with hypertension in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less was 88.5% which was 4.3% above the CCG average and 4.9% above the national average. Exception reporting was 5.6% which was 0.8% above the CCG average and 1.8% above national average.

• The percentage of patients with COPD who had a review, undertaken by a healthcare professional was 97.4% which was 8.4% above the CCG average and 7.6% above the national average. Exception reporting was 28.3 % which was 13.5% above the CCG average and 17.2% above the national average. We discussed this with the practice and found that a GP partner had reviewed the figures and found that they had a coding issue.

• The practice’s computer system alerted GPs if a patient was also a carer. % of the practice list).

• Longer appointments and home visits were available when needed.

• Patients had a named GP and the practice had a system in place for recalling patients for a structure annual review to check their health and medicines needs were being met.

Updated 17 November 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 high for all standard childhood immunisations.

• Appointments were available outside of school hours. Extended hours appointments were available at the Market Harborough Medical Centre on a Monday evening.

• The practice offered a chlamydia screening and sexual health advice service.

• The practice’s uptake for the cervical screening programme was 80%, which was comparable to the CCG and national average of 80%.

• The practice had a satellite clinic at Welford which gave parents the opportunity for their children to be seen by a GP without having to travel.

Updated 17 November 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• 2.2% of patients who had been assessed as being at risk had a care plan in place which was slightly above the required national target

• At risk patients were discussed at a monthly multidisciplinary meeting.

• The practice had a satellite clinic held at Welford which gave the opportunity for older people to be seen by a GP without having to travel.

Updated 17 November 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 offered extended opening hours for appointments on a Monday evening at the Market Harborough Medical Centre.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

• There was a good uptake for both health checks and health screening. For example, the practice had an uptake of 65% of those eligible for bowel screening which was slightly above the CCG average of 64% and national average of 60%. The practice had an uptake of 83% of those eligible for breast screening which was slightly above the CCG average of 82% but well above the national average of 70%.

Updated 17 November 2016

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

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.

• Four patients diagnosed with depression had had their care reviewed in a face to face meeting in the last 12 months.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 17 November 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 homeless people, travellers and those with a learning disability.

• 95% of patients registered at the practice with a learning disability had received a face to face annual review in the last 12 months.

• 100% of patients on the palliative care register had received a face to face review in the last 12 months. 1.84% of these patients had a care plan in place.

• 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.

• It had told vulnerable patients about how to access various support groups and voluntary organisations. For example, First Contact, a multi-agency scheme for access to a range of services for vulnerable people in Leicestershire

• 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.