Friarsgate Practice

Updated 20 December 2019

Friarsgate Practice is located at Friarsgate Surgery, Stockbridge Road, Weeke, Winchester, Hampshire SO22 6EL. The surgery has an additional site located at Badger Farm Surgery, Badger Farm Road, Badger Farm, Winchester, Hampshire SO22 4QB. We visited both sites at this inspection.

The provider is registered with CQC to deliver the following Regulated Activities from both sites:

• Diagnostic and screening procedures;
• Family planning;
• Maternity and midwifery services;
• Surgical procedures;
• Treatment of disease, disorder or injury.

Friarsgate Practice is situated within the West Hampshire Clinical Commissioning Group (CCG) and provides services to approximately 24,300 patients under the terms of a personal medical services (PMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

The provider is a GP partnership of eight GP partners who registered with the CQC in April 2013. The practice also has seven salaried GPs, three advanced nurse practitioners, a paramedic, three practice nurses, a research nurse, a healthcare assistant and a chiropractor. The clinical team is supported by a practice management team comprising of a business manager, an operations manager, a patient services manager and a reception manager. The practice has a team of receptionists, administrators and medical secretaries. The practice is part of a Primary Care Network (PCN) of GP practices with two other GP practices in Winchester. The practice is also a member of a GP federation which covers the surrounding geographical area.

There are an higher than average number of patients aged between five and 18 years, and those aged over 75 years. The National General Practice Profile states that 95% of the practice population is from a White background with a further 3% of the population originates from an Asian background. Information published by Public Health England, rates the level of deprivation within the practice population group as ten, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 81 years compared to the national average of 79 years. Female life expectancy is 85 years compared to the national average of 83 years.

Updated 20 December 2019

We decided to undertake an inspection of Friarsgate Practice following our annual review of the information available to us. This inspection looked at the following key questions of:

• Are the services at this location effective?
• Are the services at this location well-led?

The practice’s annual regulatory review did not indicate that the quality of care had changed in relation to Safe and Caring. As a result, the ratings from the practice’s previous inspection from 2014 still stands in those key questions.

During the inspection, based on what we found on inspection, we decided to also inspect the key question of:

• Are the services at this location responsive?

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 have rated this practice as good overall and outstanding for providing responsive services. We have also rated the practice as outstanding for the population groups relating to older people, people with long-term conditions and family, children and young people. The population groups relating to care of working age people, people with mental health and circumstance who make them vulnerable have been rated as good.

We found that:

• Patients received effective care and treatment that met their needs.
• The practice had implemented a new diabetic care programme to ensure consistent oversight of patient care and to improve its exception reporting performance but the impact of these changes had not yet been demonstrated.
• The practice had planned, organised and delivered services in innovative ways to meet patients’ needs.
• Patient feedback confirmed access to appointments was easy and they were able to access urgent and routine appointments when they needed them.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• Staff were proud to work at the practice but some staff were not always able to attend practice meetings to contribute ideas for improvements or developments.
• The practice responded to significant events, complaints and concerns in a timely manner. Any subsequent investigations were comprehensive and patients received a full explanation where appropriate.

We saw the following areas of outstanding practice which contributed to the outstanding rating for responsive:

• By recruiting a chiropractor and running a MSK pilot, the practice had responded to national increased demand for MSK care and treatment. Since the pilot in 2018, 387 patients had been seen by the practice’s chiropractor. Of those, 61% had been discharged with self-management advice, 15% had received a prescription, approximately 25% had been referred for further investigation or for a secondary care follow up and 17% had returned for a follow up with the practice’s chiropractor.

• The practice had proactively introduced new systems, processes, workforce arrangements and technology to ensure access to care took account of people’s individual needs including those with urgent clinical needs as well as routine needs.

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

• Develop a log of GP training records to ensure full oversight of completion performance in line with practice’s own training recommendations.
• Continue to review performance data, particularly exception reporting rates from Quality and Outcome Framework indicators, especially in relation to diabetes.
• Continue to improve the uptake for cervical screening to achieve the national target of 80%.
• Consider how staff from both sites can be included in relevant practice meetings to allow all staff members equal opportunities in contributing to learning and practice development.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care

Updated 20 December 2019

Updated 20 December 2019

Updated 20 December 2019

Updated 20 December 2019

Updated 20 December 2019

Updated 20 December 2019