Background to this inspection
Updated
15 November 2018
The Heaton Medical Practice, is located at Haworth Road Health Centre, Haworth Road, Bradford, West Yorkshire, BD9 6LL. The practice provides services for 5,663 patients under the terms of a Personal Medical Services contract. The practice buildings are accessible for those with a physical disability or mobility issues. In addition, the practice has on-site parking available for patients, with designated spaces for disabled patients who require them.
The practice population catchment area is classed as within one of the second most deprived areas in England on a scale of one to ten, with a rating of one being the most deprived and ten the least deprived. The age profile shows that the practice has a higher number of patients aged 18 years and under. This is 32% for the practice compared to 24% as a local average and 21% as a national average. Life expectancy of the practice population is in line with other GP practices in the NHS Bradford District Clinical Commissioning Group (CCG) and is lower than the national average.
The National General Practice Profile states that 57% of the practice population is from an Asian background.
The Heaton Medical Centre is registered with the Care Quality Commission to provide; surgical procedures, diagnostic and screening procedures, family planning, maternity and midwifery services and the treatment of disease, disorder or injury.
The practice offers a range of enhanced local services including those in relation to:
- childhood vaccination and immunisation
- travel vaccinations
- Influenza and Pneumococcal immunisation
- Joint injections
As well as these enhanced services the practice also offers additional services such as those supporting long term conditions management including spirometry for lung conditions, ECG and blood pressure monitoring, advice and support for alcohol misuse, weight loss and social prescribing including help in accessing welfare benefits.
Allied with the practice is a team of community health professionals that includes health visitors, community matrons, midwives and members of the district nursing team.
The clinical team consists of one part-time locum GP (male) providing four clinical sessions each week, two full-time Advanced Nurse Practitioners (one male, one female), one practice nurse and a health care assistant (both female). Additional GP locums are booked on an as required basis and could be either gender dependent on availability. The GP partnership does not provide any clinical sessions, with the exception of an occasional joint-injection clinic provided by one of the partners. The clinical team is supported by an onsite part-time assistant practice manager and a team of administrative and management support staff. The business manager works full time at another location, but is available via the telephone and undertakes occasional visits to the site as required.
The practice appointments include:
- Pre-bookable appointments
- Urgent and on the day appointments
- Telephone consultations
- Home visits
Appointments can be made in person or by telephone.
Practice opening times are:
Monday - 8am to 6.30pm
Tuesday – 8am to 8.30pm
Wednesday – 8am to 6.30pm
Thursday – 8am to 6:30pm
Friday – 8am to 6.30pm
Out of hours care is provided by Local Care Direct, reached by dialling 111.
The previously awarded ratings are displayed as required in the practice and on the practice’s website.
Updated
15 November 2018
We carried out an announced comprehensive inspection at The Heaton Medical Practice name on 11 September 2018, as part of our inspection programme.
At this inspection we found:
- Staff were not sufficiently trained in safeguarding awareness relevant to their role.
- The provider had not acted on issues identified during a recent infection prevention and control audit or ensured that all staff were trained in infection prevention and control.
- The provider did not consistently ensure that a GP was onsite, and Advanced Nurse Practitioners were routinely seeing acutely ill children under the ages of two years, without having received enhanced training to undertake this role.
- Newly appointed staff did not have a programme of planned training as part of their induction or documented updates on their progress. The practice provided staff with limited ongoing support.
- During the inspection, we identified 210 outstanding test results on the system, 62 of these dated back to January 2018.
- Temperature sensitive medicines were not transported to patients’ home in an approved medical grade cool box.
- Prescription stationery was not monitored by the provider for audit and security purposes.
- There was an absence of risk assessment activity, including both fire and Health and Safety.
- The provider’s management of significant events and learning from them was insufficient.
- The practice could not consistently ensure that End of Life care was delivered in a coordinated way because there were insufficient GPs available to visit patients in need.
- There was not an effective system in place for following up patients with a mental illness who failed to attend for their appointments.
- The practice did not have a full understanding of the learning needs of staff and did not consistently provide protected time and training to meet them. We received mixed views from staff we interviewed; some staff felt well-supported whilst others told us they felt left to cope in a high-pressure environment.
- Members of the leadership team, which comprised the Registered Manager, second GP partner and the Business Manager did not visit the site on a regular basis or maintain effective oversight of activities at the location.
- The leadership team did not arrange or attend meetings with either the clinical or non-clinical team. We saw that the practice had not had a staff meeting since March 2018.
- A range of policies we reviewed contained out of date information. Staff were not sufficiently trained or aware of their role in notifying external organisations of significant events.
- The provider had not shared the findings of the survey with the staff team or drafted an action plan to address the issues raised.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- Ensure there is an effective system for identifying, receiving, recording, handling and responding to complaints by patients and other persons in relation to the carrying on of the regulated activity.
The areas where the provider should make improvements are:
- Improve the provision of independent interpretation services for patients who need this service to be assured of their privacy, dignity and safety.
I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
We are taking further action in line with our enforcement processes. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.
Special measures will give people who use the service the reassurance that the care they get should improve.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice