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Haxby Group Kingswood Surgery Outstanding

Reports


Review carried out on 7 October 2021

During a monthly review of our data

We carried out a review of the data available to us about Haxby Group Kingswood Surgery on 7 October 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Haxby Group Kingswood Surgery, you can give feedback on this service.

Review carried out on 21 December 2019

During an annual regulatory review

We reviewed the information available to us about Haxby Group Kingswood Surgery on 21 December 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 29 November 2018 to 30 November 2018

During a routine inspection

We carried out an announced comprehensive inspection at Haxby Group Kingswood Surgery on 29 November 2018 as part of our inspection programme.

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 outstanding overall. We rated the population groups of families, children and young people and people whose circumstances may make them vulnerable as outstanding and older people, people with long term conditions and people experiencing poor mental health (including people with dementia) as good.

We found that:

  • 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.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. The Group had developed a new access model and was one of the first to introduce new roles into general practice. This meant that patients could access care and treatment in a timely way, with the most appropriate healthcare professional.
  • The way the practice was led promoted the delivery of high-quality, person-centred care.

We saw areas of outstanding practice;

  • The Group had effective support mechanisms in place for staff training. They had developed bespoke induction packs for different staff roles. They implemented competency based framework for all roles to be effectively assessed and provided support until they were achieved. Staff feedback was consistently positive with regards to the training provided.
  • The Group had implemented effective services for their patients including effective approaches to flu and childhood immunisations. They could demonstrate the positive impact this had for patient outcomes.
  • The Group offered patients the opportunity to self-administer an injectable contraceptive that was a suitably licensed preparation for patient self-administration. The practice nursing team provided education and support to patients. The service gave patients choice and increased the availability of nurse appointments.

  • The Group had developed up to date templates. This reduced variability in coding as well as improving the safety of work carried out by new members of staff, clinical trainees and locums. The templates also promoted patient safety through prompts for clinicians during and after consultations to ensure referrals and investigations were completed.
  • The Group had made improvements to their services for palliative care patients. Palliative care champions had been established, the champions had been given extended training in how to deal with bereavement, how to prioritise palliative care issues and how to liaise with specialist services such as the hospice and Macmillan nurses.

  • We were shown evidence that GPs were now twice as likely to add a palliative care patient to the palliative care register (22% of palliative care patients identified by a GP in 2015 and 42% of palliative care patients identified by a GP in 2018). We also noted that anticipatory drugs were now being reviewed at regular intervals. (33% in 2015 and 63% in 2018).

  • The Advanced Training Practice (ATP) hub was instrumental in supporting pre- registration student nurses to have clinical placement experience, to encourage them to consider practice nursing at the point of qualification.

The areas where the provider should make improvements are:

  • Where patients are prescribed medicines not in line with National Institute for Clinical Excellence guidance provide a rationale as to why another medicine was prescribed within the patient record. This should include patients who had not been prescribed a high intensity statin as recommended by National Institute for Clinical Excellence guidance.

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

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Inspection carried out on 23 August 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Haxby Group Practice on 23 August 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.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • 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.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • 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 several areas of outstanding practice including:

  • Implementing the Integrated Primary Care Team (IPCT) hub working to support patients who were at risk of hospital admission, to stay at home with support.

  • The Advanced Training Practice (ATP) hub was instrumental in supporting pre- registration student nurses to have clinical placement experience, to encourage them to consider practice nursing at the point of qualification.

  • Haxby Group has led in introducing practice pharmacists to support for example; repeat prescribing, medication queries and increased safety.

  • The practice had adopted the Gold Standards framework quality improvement programme for how they care for patients approaching their end of life (palliative care). The practice had increased its palliative care reviews with other health professionals from 25% (February 2015 – July 2015) to 92% (February 2016 – July 2016).

  • The practice also had a dedicated nominated lead to support patients with a learning disability. Regular assessments of needs took place as part of a patients disability check. For example, seasonal reviews, dementia, breast examinations, audiology and dental examinations. Reviews took place in conjunction with the known carers of the patients to ensure continuity of care and support. An example of continued care and support is learning disability patients undertaking a dental examination under sedation also have their blood test taken at the same time following a best interest meeting.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice