Hawthornden Surgery - Care Quality Commission

Background to this inspection

Updated 23 August 2017

Hawthornden Surgery is situated in Bourne End, Buckinghamshire within a converted premises. All patient services are offered on the ground and first floors. Hawthornden Surgery comprises of five consulting rooms, two treatment rooms, two patient waiting areas, a reception area, administrative and management office.

Hawthornden Surgery has core opening hours from 8am to 6.30pm Monday to Friday. The practice offers a range of scheduled appointments to patients every weekday from 8.30am to 5.50pm including open access appointments with a duty GP throughout the day. The practice offers extended hours appointments fortnightly every Wednesday from 7am to 8am, fortnightly every Thursday from 6.30pm to 8.30pm, one Tuesday a month from 6am to 8am and one Saturday a month from 8.30am to 2pm.

The practice has a patient population of approximately 7,040 registered patients. The practice population of patients aged between 0 to 39 years old is lower than the national average and there are a higher number of patients aged above 50 years old compared to national average.

Ethnicity based on demographics collected in the 2011 census shows the patient population is predominantly White British and 5% of the population is composed of patients with an Asian, Black or mixed background. The practice is located in parts of Bourne End and Flackwell Heath with the lowest levels of income deprivation in the area.

There are six GP partners at the practice. Three GPs are female and three male. The practice employs two practice nurses and a health care assistant. The practice manager is supported by an IT manager, an administration manager, a team of administrative and reception staff. Services are provided via a General Medical Services (GMS) contract (GMS contracts are negotiated nationally between GP representatives and the NHS).

Services are provided from following location. We visited the practice during this inspection.

Hawthornden Surgery

Wharf Lane

Bourne End

Buckinghamshire

SL8 5RX

The practice has opted out of providing out of hours services to their patients. There are arrangements in place for services to be provided when the practice is closed and these are displayed at the practice, in the practice information leaflet and on the patient website. Out of hours services are provided during protected learning time by Care UK Primary Care service or after 6:30pm, weekends and bank holidays by calling NHS 111.

Overall inspection

Good

Updated 23 August 2017

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at Hawthornden Surgery on 5 December 2016 found breaches of regulations relating to the safe and well-led delivery of services. The overall rating for the practice was requires improvement. Specifically, we found the practice inadequate for the provision of safe services and require improvement for provision of well led service. It was good for providing effective, caring and responsive services. Consequently we rated all population groups as requires improvement. The full comprehensive report on the previous inspections can be found by selecting the ‘all reports’ link for Hawthornden Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 9 August 2017 to check that the practice was meeting the regulations and to consider whether sufficient improvements had been made.

We found the practice had made improvements since our last inspection. At this inspection we found the practice was meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the practice is now rated as good. Consequently we have rated all population groups as good.

Our key findings were as follows:

Risks to patients were assessed and well managed.
During the previous inspection in December 2016 we found high risk issues relevant to the suitability of the premises and health and safety procedures at the branch practice. However, the practice had taken urgent steps and stopped offering appointments at the branch practice from the day after that inspection.
The practice had carried out patients’ consultation and submitted a formal application in March 2017 to close the branch practice (Flackwell Surgery). NHS England had approved the application and the branch practice was formally closed on 20 June 2017.
All the areas of concerns identified during the previous inspection relating to the branch practice had been resolved due to the permanent closure of the branch practice.
Improvements had been made to maintain a safe system for medicines management including the safe storage of medicines requiring refrigeration.
Vaccines were safely stored and the fridge temperatures were monitored daily and records maintained.
The practice had carried out a fixed electrical installation check to ensure safety of the wiring system.
The practice demonstrated improvement in governance arrangements.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice