Background to this inspection
Updated
12 June 2018
Fisher Medical Centre is located in the centre of the town of Skipton at Millfields, Coach Street, Skipton BD23 1EU. The practice also has a branch surgery at Hightlands, Gargrave, Skipton BD23 3RF. They have 14,137 registered patients. They have a higher than national average population of patients aged over 45 to 85+ years. The practice is in the 9th decile of deprivation i.e. within the 20% least deprived areas in the country. The population is predominately white British with only 3.7% from black and minority ethnic group. It is part of NHS Airedale, Wharfedale and Craven Clinical Commissioning Group (CCG). The practice covers a large rural population. The practice is registered to provide the regulated activities of surgical procedures, family planning, treatment of disease, disorder or injury, diagnostic and screening procedures and maternity and midwifery services.
The practice provides General Medical Services (GMS) under a contract with NHS England. The practice is also contracted to provide a number of enhanced services, which aim to provide patients with greater access to care and treatment on site. They offer enhanced services in; childhood vaccinations and minor surgery.
There are ten GPs, four male and six female (seven are GP Partners with three salaried GPs), an Advanced Nurse Practitioner, six Practice Nurses, three Health Care Assistants, one Physiotherapist and two Practice based Clinical Pharmacists.
The practice were displaying the previously awarded rating in the surgery and on the website.
The practice is open between 8am and 6.00pm Monday to Friday and alternate Saturday mornings. The practice is closed for training one afternoon a month. When the practice is closed, out-of-hours services are provided by Local Care Direct (LCD).
The practice is a training practice for medical students, physician associates, foundation year students, GPs and nurses.
Updated
12 June 2018
This practice is rated as Good overall. (Previous inspection 23/06/2016 – Good)
The key questions 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 Fisher Medical Centre on 10 April 2018, as part of our inspection programme.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- There was evidence of safe prescribing with reviews undertaken with those patients who were prescribed high risk medicines.
- There was evidence of comprehensive poly pharmacy reviews for patients.
- Patients’ comments were positive regarding access to appointments and the service they received from practice staff.
- The practice had a number of health champions to support a variety of aspects of care.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- There was evidence of a cohesive practice team. Support and respect was shown by all members of staff towards one another.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- There was a range of inclusive meetings to ensure all staff were engaged and kept up to date. This included a daily briefing at five minutes to eight each morning.
The areas where the provider should make improvements are:
- The provider should ensure that the same process is used at the branch surgery as the main surgery with regard to recording minimum and maximum refrigerator temperatures.
- The provider should ensure that prescription pads are locked away securely at the branch surgery when the building is not occupied.
- The provider should ensure there is a systematic process to ensure the competencies of non-medical prescribers in the practice.
- The provider should review and improve quality activity, particularly audits of two or more cycles, in order to demonstrate improvements to outcomes for patients as a result.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice