Archived: Hurst & Hurst Also known as Hartington Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hurst and Hurst, Hartington Surgery on 5 July 2016.

Overall the practice is rated as outstanding. Our key findings across all the areas we inspected were as follows:

• Importance was placed in treating patients with dignity and respect. The practice had recently received the Derbyshire Dignity Campaign Award, an initiative developed by the local County Council.
• Overall feedback from patients was extremely positive with regards the care and services they received. Patients said they were treated with compassion, dignity and respect, and were involved in decisions about their care and treatment.
• Patient survey satisfaction scores in respect of care and how they were treated were significantly above local and national averages. 
• Feedback from community based staff we spoke with, was consistently positive with regards to the high levels of care provided by the practice team.
• The services were delivered in a way to ensure flexibility, choice and continuity of care.
• The appointment system and services were flexible to meet the needs of patients. Most patients told us they were able to access appointments or telephone consultations in a way, and at a time that suited them.
• ​The standard appointment times for all clinical staff with the exception of locum GPs, had been extended from 10 to 15 minutes for each patient. This meant that the clinical staff had more time to assess patients needs, and provide advice and support.
• Patients lived over a vast rural area. The practice had a small staff team who lived in the area, and had a wealth of local knowledge and knew their patients well.  
• The practice had  close links with the local community and  worked in partnership with other services to meet patients’ needs.
• The practice provided a range of services on site to enable patients to be treated locally and in response to their needs. For example, the provision of 24 hour cardiac monitoring ( including interpretation)  is funded by the practice in response to patients’ needs.
• The premises were on one level and provided good access and facilities for patients, and were well equipped to meet their needs.
• There was an open and transparent approach to safety. Effective systems were generally in place to keep patients safe, including the management of medicines.
• There was evidence of quality improvement including clinical audits. The culture and leadership empowered staff to carry out lead roles and to drive continuous improvements.

• The practice had a highly motivated, experienced and cohesive staff team to enable them to deliver well-led services. 

• The culture supported learning and innovation.​  The commitment to learning and the development of staffs’ skills was recognised as essential to ensuring high quality care. Staff development was encouraged and we saw how individuals had taken on new roles with the support of senior staff. 

• The practice actively sought the views of patients and staff, which it acted on to improve the services. The patient participation group (PPG) had been established 27 years , and continued to influence practice developments. The PPG worked in partnership with the practice  and were actively involved with many aspects of the practice’s work.

• Complaints were listened to and acted on to ensure that appropriate learning and improvements had taken place.

​We saw several areas of outstanding practice including:

• In response to the problems associated with rural isolation and lack of local services, a practice nurse provided a home assessment service and health checks, for elderly, housebound and vulnerable patients. This helped to identify health or social issues that may not have been reported, and ensure patients needs were met.
• The practice population included a large farming community. The staff team had built up strong relationships with the farming families, to increase their willingness to access support and health services locally. The practice worked closely with the Farming Life Centre, a local charity dedicated to improving the quality of life of farmers and rural communities through its services.

​Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice