Pershore Medical Practice

Updated 10 November 2022

Pershore Medical Centre is located in Pershore.

Pershore Medical Centre

Queen Elizabeth House

Queen Elizabeth Drive

Pershore

WR10 1PX

The practice has a dispensary service located on site which was also inspected as part of our inspection activity.

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

The practice is situated within the NHS Herefordshire and Worcestershire Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 10,659. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices known as the Pershore and Upton Primary Care Network (PCN) consisting of three practices in total.

Information published by Public Health England shows that deprivation within the practice population group is in the seventh decile (seven of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 98.9% White, 0.5% Mixed, 0.4% Asian.

The practice has a higher than national average number of people who have reached retirement age. It has lower than the national average number of adults at working age and young people.

There is a team of five GP partners and five salaried GPs. The practice has a team of three practice based clinical pharmacists and a paramedic. The practice also has three advanced nurse practitioners, as well as six practice nurses and two health care assistants. The Practice Manager is supported by the Assistant Practice Manager, four departmental managers and a team of reception, secretarial and administration staff.

The practice is open between 8:00 am to 6:30 pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and book in advance appointments.

Updated 10 November 2022

We carried out an announced comprehensive at Pershore Medical Practice on 21 September 2022. Overall, the practice is rated as good.

Safe - good

Effective - good

Caring - good

Responsive - good

Well-led - good

Following our previous inspection on 17 September 2015, the practice was rated outstanding overall and specifically for the key questions of effective and responsive. Safe, caring and well led were rated as good.

At the last inspection we rated the practice as outstanding for providing effective and responsive services because:

• The practice was outstanding at providing services for people with long term conditions and people in vulnerable circumstances. The practice was good at providing services for older people, families, children and young people, the working age population and those recently retired and people experiencing poor mental health.

At this inspection, we found that those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. The practice is therefore now rated good for providing effective and responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Pershore Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection as part of our ongoing monitoring following up on the previous comprehensive inspection. Therefore, as part of this comprehensive inspection we inspected all five key questions: safe, effective, caring, responsive and well-led. This inspection included a comprehensive review of information and a site visit where we inspected safe, effective, responsive and well-led care. Additionally, we reviewed access to the practice via telephone and a patient’s ability to book in with a named GP.

How we carried out the inspection/review

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently. Therefore, as part of this inspection we completed clinical searches on the practice’s patient records system and discussed the findings with the provider. This was with consent from the provider and in line with all data protection and information governance requirements.

The inspection also included:

• Requesting and reviewing evidence and information from the service
• A site visit
• Conducting staff interviews
• Reviewing patient records to identify issues and clarify actions taken by the provider

Our findings

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 found that:

• The practice was actively involved in initiatives used to identify patients with high cholesterol enabling the practice to treat their conditions more effectively.
• We found that systems were in place to support and share access information with other services to support the care and treatment of patients with learning disabilities.
• The practice was providing support to people to use equipment at home and were using children’s heel prick tests to identify parents who may have undiagnosed high levels of cholesterol.
• Staff were consistent and proactive in helping patients to live healthier lives.
• Staff treated patients with kindness, respect and compassion. Feedback from patients was positive about the way staff treated people.
• The practice consistently reviewed and improved the way people were able to access care and treatment.
• The practice had a culture good quality sustainable care.
• The practice had systems, practices and processes to keep people safe and safeguarded from abuse however these were not always effective. In particular, we found that disclosure and barring service (DBS) checks were not routinely being carried out as part of the recruitment process. Following our inspection the practice demonstrated that they had obtained evidence of DBS checks from staff members’ previous employers.

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

• Strengthen monitoring systems to ensure staff have the skills, knowledge and experience to carry out their roles.
• Establish systems to demonstrate that clinical supervision is being carried out
• Continue taking action to improve uptake of childhood immunisations and cervical cancer screening
• Continue to strengthen recruitment systems to ensure staff are suitable for their role and safe for deployment within the practice.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services