This practice is rated as Good overall. (Previous inspection 10/2014 – Good)

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 Hawthorn Medical Centre on 20 March 2018, 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.
• 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.
• 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.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw three areas of outstanding practice:

• There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that met these needs and promoted equality. The practice introduced changes to the appointments booking service for wound care clinics. A telephone triaging system reduced the time from patients calling for an appointment, to receiving an appointment with the appropriate healthcare professional. Recent data reviewed at the time of inspection showed that average waiting times to see an appropriate healthcare professional were reduced from four days to around one-and-a-half days.
• Following changes to the appointments booking service, data on lower leg wound healing rates improved.

• The practice routinely referred patients with (or at risk of developing) Type II diabetes to a range of services to help monitor and improve their health, wellbeing and performance. Examples of this included a diabetic clinic with a local diabetic consultant, an education program and online software tools.

There are areas where the provider should make improvements.

• The provider should continue to make efforts to increase the programme coverage of women eligible to be screened for cervical cancer.
• The provider should continue to make efforts to improve patient access to appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Hawthorn Medical Centre is a GP practice situated in Swindon and has approximately 12,000 registered patients. Our inspection team was led by a CQC Lead Inspector. The team included a GP, a practice manager and two practice nurses. All team members had been involved in previous CQC inspections across a range of service types including, GP practices and hospitals. All team members had many years’ experience in their fields of employment

We carried out an announced, comprehensive visit on 1 October 2014. During our visit we spoke with a range of staff. These included GP partners, salaried GPs, nurses, a health care assistant, a phlebotomist (someone who is trained to take blood samples) and administration staff. We also spoke with patients who used the practice and we reviewed comment cards where patients shared their views and experiences of treatment and care provided by staff.

Before visiting, we reviewed a range of information we held about the practice and asked other organisations to share what they knew. This included the Swindon Clinical Commissioning Group (CCG), NHS England and Healthwatch Swindon.

The overall rating for Hawthorn Medical Practice is good. Our key findings were as follows:

• Patients felt they were treated with kindness and professionalism.
• Mechanisms were in place to report and record safety incidents, including concerns and near misses, and to learn from them.
• The practice was clean and tidy, and infection prevention and control protocols were implemented.
• There weresix weeklygold standard framework meetings with the multi-disciplinary team which consisted of community district nurses, mental health nurses, health visitors to discuss and meet the needs of patients with palliative care needs.
• As a result of a high rate of referrals to hospital to the ENT (ear, nose and throat), general surgery and rheumatology. Consequently the practice put in place a system of GP peer review to look at the consistency of its referrals and to identify reasons why the referral rate was high.

We saw several areas of outstanding practice including:

• In response to a prevalence of obesity and diabetes in the local population, the practice had developed an innovative service for patients with diabetes which included a specialist diabetes clinic where patients with complex needs were started on insulin/injectable treatment without the need to be referred to a hospital. Two of the GP partners were trained to run these clinics, which were linked with a hospital consultant who specialised in diabetes.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice