Background to this inspection
Updated
14 August 2018
Todmorden Group Practice is situated in Todmorden, Calderdale. There are currently 13,517 patients registered on the practice list. The practice provides General Medical Services (GMS) under a locally agreed contract with NHS England.
The practice is registered with the Care Quality Commission to provide the following regulated activities:
- Treatment of disease, disorder or injury
- Diagnostic and screening procedures
- Family planning
- Maternity and midwifery services
- Surgical procedures
The practice is housed in modern, purpose built premises which are shared with another practice and a walk-in centre. The practice building hosts several additional services such as medical consultants in cardiology, rheumatology, psychiatry, gynaecology and paediatrics; as well as X Ray and ultrasound services, podiatry, diabetic retinal eye screening and a young person’s clinic for sexual health services.
The Public Health General Practice Profile shows the majority of the practice population to be of white British origin, with around 4% of mixed or Asian ethnicities. The level of deprivation within the practice population is rated as five, on a scale of one to ten. Level one represents the highest level of deprivation and level ten the lowest.
The age/sex profile of the practice is largely in line with national averages. The average life expectancy for patients at the practice is 78 years for men and 82 years for women, compared to the national averages of 79 years and 83 years respectively.
The practice offers a range of enhanced services:
- Meningitis vaccination and immunisation
- Childhood vaccination and immunisation
- Extended hours access
- Facilitation of timely diagnosis and support for dementia
- Influenza and pneumococcal immunisation
- Support for patients with learning disabilities
- Minor Surgery
- Rotavirus and shingles immunisation
The practice is a training practice, which means it provides training and support for qualified doctors wishing to specialise in general practice. A GP registrar was due to begin their placement at the practice the week following our visit.
There are four GP partners, two male and two female. One of the GPs was due to retire within the next few months following our inspection, and a salaried GP was being recruited in their place. The practice also makes use of regular locums. A female clinical pharmacist is also in post. The clinical team also includes four female advanced nurse practitioners, three female practice nurses and two female health care assistants (HCAs).
Supporting the clinical team is a practice manager, deputy practice manager and a range of secretarial, administrative and reception staff.
Out of hours care is provided by Local Care Direct and can be accessed by calling the surgery telephone number or by calling the NHS 111 service.
When we returned for this inspection we checked, and saw that the previously awarded ratings were displayed, as required, in the practice premises and on the practice website.
Updated
14 August 2018
This practice is rated as Good overall. The practice was previously inspected on 6 December 2017 and received a rating of Requires Improvement for providing safe and well led services, which led to a rating of Requires Improvement overall.
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Todmorden Group Practice on 26 July 2018. We carried out this inspection to review the changes the practice had implemented since their previous inspection, and to follow up on the breach of regulation identified at that time.
At this inspection we found:
- The practice had revised their staffing structure and had identified clear leadership areas in relation to clinical and non-clinical governance. Staff were clear about the leadership structure and their roles and responsibilities within the organisation.
- There were appropriate systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them, communicated them to staff, and improved their processes.
- Policies and protocols in relation to staff activity had been reviewed and updated. We viewed a sample of these and saw they were up to date and gave relevant guidance.
- Staff recruitment, training and ongoing monitoring processes had been reviewed. These were effective and safe.
- Health and safety issues were addressed in the practice. An external agency provided and updated risk assessments to support the provision of a safe environment for staff and patients.
- Staff told us the practice had a culture of openness and the senior leadership team was supportive.
- The practice had good facilities and a number of additional services including hospital consultant clinics were available to patients on site.
- The practice was part of ‘Calderdale Group Practice’, a group of 11 practices developing shared back office functions to improve resilience.
- The practice reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to up to date evidence based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patient feedback in relation to the appointment system was mixed. Some patients told us GP appointments could be difficult to obtain.
- Continuous learning and improvement was supported for all staff via the appraisal process.
The areas where the provider should make improvements are:
- Embed communication systems and processes in the practice to ensure that there is a sustained forum for two-way staff feedback.
- Continue to review and improve access to the practice, including GP appointments for patients and telephone access in general.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.