Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Humshaugh and Wark Medical Group on 3 February 2016. Overall, the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Lessons were learned when incidents and near misses occurred.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• Patients said they were able to get an appointment with a GP when they needed one.
• Extended hours surgeries were offered up to 7:30pm one evening each week at each surgery.
• Urgent appointments were available on the day they were requested.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• Patients could access appointments and services in a way and a time that suited them. Data from the National GP Patient Survey published in July 2015 showed that patients rated the practice highly for accessibility. For example, 100% said the last appointment they got was convenient (CCG average of 93%, national average of 92%) and 99% found it easy to get through to the surgery by phone (CCG average 77%, national average 73%).

There are two areas where the provider should make improvements:

The provider should:

• Review the records and storage of blank prescriptions to ensure that these are stored in line with national guidance and kept securely at all times.
• Review the management of complaints at the practice; verbal complaints should be recorded in line with their agreed complaints policy.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People expressed their views and were involved in making decisions about their care. One patient said, “The doctors and nurses are good listeners.” Another patient told us, “The practice is very supportive and helps me to solve my problems.” Reception staff told us that if a patient needed to speak in private, they would try to find an empty room.

The practice had in place safeguarding policies for both children and vulnerable adults. There was an identified lead clinician with clear roles and responsibilities to oversee safeguarding within the practice. Safeguarding training was updated as part of a rolling three year programme. Information about safeguarding and domestic violence was on display within the practice.

There were effective systems in place to reduce the risk and spread of infection. The practice had an identified clinician to lead on infection control. The practice was well organised and presented as clean tidy and generally well maintained.

People were protected against the risks associated with medicines. The practice had systems in place for ordering and replacing drug stock. The lay-out of medicines on the shelves followed advice from the British National Formulary. Patients were able order repeat medication in person at the surgery, or via a dedicated telephone line.

The practice operated an effective recruitment system. General practitioners and nurses employed were checked to ensure they had an up to date professional registration.

We carried out an announced comprehensive inspection at Humshaugh and Wark Medical Practice on 5 March 2019 as part of our inspection programme.

At the last inspection in February 2016 we rated the practice as good overall and for delivering safe, effective, caring, responsive and well-led services.

We have 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 have rated this practice as good overall and good for all population groups.

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs. Good systems were in place to ensure patients attended long term condition and medication reviews.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care. Patient feedback about the practice and its staff was consistently positive.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• The practice was responsive to the needs of their local population. Due to their rural location and poor transport links they dispensed medicines to approximately 88% of their patient population and operated a medicines delivery service for over 260 patients.
• The practice had performed well in ensuring eligible women had attended cervical screening and children had received childhood immunisations.

We saw an area of outstanding practice:

• The practice was seeking alternative methods of engaging with their patients and the local community. The practice nurse had attended assemblies at two local primary schools to give talks on germs, handwashing techniques and what to expect of the nasal flu immunisation. The practice nurse and assistant practitioner were due to give a talk at the local Women’s Institute to promote health and well-being.

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

• Continue with plans to carry out fire drills at both surgeries.
• Continue with plans to check and record staff immunity status in relation to measles, mumps and rubella.
• Implement a system to log and monitor the movement of handwritten prescription stationery.
• Implement a system to ensure minor surgery histology results are received.
• Arrange for practice nurses to undertake level three safeguarding training.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice