Harcourt Medical Centre

Background to this inspection

Updated 13 April 2017

Harcourt Medical Centre is located close to the centre of Salisbury in an old listed building with a modern extension. All areas accessed by patients are in the new extension and are on one level.

The practice has a slightly higher than average patient population over 60 years old and slightly lower than average between 20 and 45 years old.

The practice is part of the Wiltshire Clinical Commissioning Group and has approximately 11,800 patients. The practice area is in the low to mid-range for deprivation nationally, although it is important to remember that not everyone living in a deprived area is deprived and that not all deprived people live in deprived areas.

There are six GP partners and two salaried GPs making the whole time equivalent of five GPs. Five of the GPs are male and three are female. They are supported by four practice nurses, one care of the elderly nurse, one health care assistant, one phlebotomist and an administrative team of 11 staff led by the practice manager.

Harcourt Medical Centre is a training and teaching practice. (A teaching practice accepts provisionally registered doctors undertaking Foundation training while a training practice accepts qualified doctors training to become GPs who are known as Registrars.) At the time of our inspection they had one registrar and one doctor undergoing foundation training working with them.

The practice is open between 8am and 6.30pm on Monday, Wednesday, Thursday and Friday, and from 9am to 6.30pm on Tuesday. GP appointments are available between 8am and 11.10am and 3pm and 5.30pm Monday to Friday, except Tuesday when routine appointments start at 9am and Thursday when the last appointment is at 6pm. Extended hours appointments are offered from 6.30pm to 7pm on Monday, 7.30am to 8am on Tuesday and 7.30am to 8am on Wednesday and Friday. Appointments can be booked over the telephone, online or in person at the surgery.

When the practice is closed patients are advised, via the practice website that all calls will be directed to the out of hours service. Out of hours services are provided by Medvivo

The practice has a General Medical Services contract to deliver health care services. This contract acts as the basis for arrangements between NHS England and providers of general medical services in England.

The practice provides a number of services and clinics for its patients including childhood immunisations, family planning, minor surgery and a range of health lifestyle management and advice including asthma management, diabetes, heart disease and high blood pressure management. Psychological support services are provided on site by the NHS.

The practice provides services from the following location:-

Harcourt Medical Centre, Crane Bridge Road, Salisbury, SP2 7TD.

Overall inspection

Good

Updated 13 April 2017

Letter from the Chief Inspector of General Practice

When we visited Harcourt Medical Centre on 31 August 2016 to carry out a comprehensive inspection, we found the practice was not compliant with the regulation relating to receiving and acting on complaints. Overall the practice was rated as good.

We found the practice required improvement for the provision of responsive services, because the complaints policy did not meet the recognised guidance and contractual obligations for GPs in England. Letters sent to patients in response to their complaint did not include information about how to escalate the complaint if they were not satisfied.

We also said the practice should:

Develop and adopt a significant events policy.
Improve their identification of carers.
Improve the accessibility of policies and procedures to all staff.

Following the inspection the provider sent us an action plan that set out the changes they would make and subsequently supplied information to confirm they had completed the actions.

This focused desk-based inspection was undertaken to ensure that the practice was meeting the regulation previously breached. For this reason we have only rated the location for the key questions to which this related. This report should be read in conjunction with the full report of our inspection on 31 August 2016, which can be found on our website at www.cqc.org.uk.

We found the practice had made improvements since our last inspection. The information we received enabled us to find the practice was meeting the regulation that it had previously breached.

Specifically Harcourt Medical Centre:

Had reviewed and revised their complaints policy and it now met the recognised guidance and contractual obligations for GPs in England.
Letters sent to patients were clear, gave an apology, a summary and included information about how to escalate the complaint if they were not satisfied.
Had developed and adopted an appropriate significant events policy.
Showed us evidence that their actions to improve the identification of carers had resulted in more carers being identified. Since our inspection in August 2016 the number identified had risen from 64 (0.7% of practice list) to 153 which is 1.3% of the practice list.
Had reviewed the accessibility of their policies and procedures, and had improved staff access to these documents by putting them onto a shared computer drive which could be accessed by all staff from their computer desktop.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice