Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Orchard Croft Medical Centre and Netherton branch surgery on 21 September 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.

• Data showed patient outcomes were at or above average compared to the national average.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• There was continuity of care, with urgent appointments available the same day.
• The practice had recognised some low patient satisfaction with regard to access and had put in place measures such as increasing the numbers of telephone lines to improve this.

• There was evidence of appraisals and personal development plans for all staff.

• The practice had developed their own advice and resources to support staff such as an advice note containing simple information to improve prescribing and medicines optimisation.

• 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.

There was an area of outstanding practice:

• In 2016 the practice had begun to offer atrial fibrillation screening. From 1 April 2016 399 patients have been screened and identified 16 patients who needed further investigation. Of these patients, six were identified as suffering from atrial fibrillation and had received effective follow up care.

There were areas where the provider should make improvements:

• Review and address the areas of concern which had not been actioned in relation to the Infection Prevention and Control (IPC) audit which had been carried out at the Netherton branch surgery in July 2015.

• Review the clinical waste storage arrangements at the Netherton branch surgery. At the time of inspection the bulk waste bin was outside the practice awaiting collection. The bin lid was not secured due to a missing lock and therefore the clinical waste stored inside was open to the public.

• Review the immunity status of staff in relation to measles, mumps, rubella and chickenpox in order to assure themselves that their staff are adequately protected in line with the latest guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Orchard Croft Medical Centre is located in a purpose built facility in Horbury, Wakefield. The practice also has a branch site, Netherton Surgery in Netherton. In this inspection we visited both sites.

Prior to the inspection we met with Wakefield Clinical Commissioning Group and the NHS England Local Area Team to discuss the practices performance.

The patients we spoke with and those who completed our Care Quality Commission (CQC) comment cards were very complimentary about the care provided by staff at the practice. Patients reported that staff treated them with dignity and respect.

Orchard Croft Medical Centre is well maintained and clean. However there were some issues with the Netherton Surgery building.

The leadership team are approachable and visible. There are appropriate governance and risk management measures in place.

The practice is registered with the Care Quality Commission to deliver care under the following regulated activities: Diagnostic and screening procedures, family planning, surgical procedures, treatment of disease, disorder or injury.