Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection May 2015 – Rated Good Overall)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dr RW Harrison & Mrs CM Harrison-Bevan (also known as Howden Medical Centre) on 15 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

Review the systems in place for reviewing changes introduced following significant events and complaints to assess whether the changes have been effective and embedded into practice.

Review the process for regular monitoring of prescriptions that have not been collected.

Implement a planned clinical audit/quality assurance programme to ensure audit cycles are completed and relevant staff are involved in the process.

Review the system that identifies patients who are also carers to help ensure that all patients on the practice list who are carers are offered relevant support if appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Howden practice on 12 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring and responsive services and for being well led. It was good for providing services to the population groups of people with long term conditions, families and young people, working age people (including those recently retired and students), and people whose circumstances may make them vulnerable and outstanding for older people and people experiencing poor mental health.

The practice was part of a Federation along with ten other practices. They used external peer review to look at referral patterns. There was a ‘flying doctor service, available from 9am to 6pm, funded by the CCG and used within the eleven practices. A GP was available for this either from one of the practices or through an agency. This service was mainly aimed at preventing unplanned hospital admissions.

The practice employed a healthcare professional who visited the housebound patients, taking bloods for testing and also for the dementia checks. She also carried out basic monitoring of chronic diseases and gave patients their flu vaccinations. This assisted the practice and patients since the District Nurses roles have been restricted.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice