Background to this inspection
Updated
29 November 2018
Tower House Practice is located in St Paul’s Health Centre, High Street, Runcorn, WA7 1AB. The practice is part of Halton Clinical Commissioning Group and all services are delivered under a General Medical Services (GMS) contract. Information on services offered can be found on the practice website at www.towerhousepractice.co.uk.
The practice is situated in a purpose-built health centre, co-owned with one other practice also in the building. A number of community services also occupy the premises. The practice is fully accessible to any patients with restricted mobility, wheelchair users and parents with prams and pushchairs. There is parking nearby available for patients and the practice is easily accessible by public transport.
The practice provides services to 13160 registered patients. Data shows the practice population is similar to the national population profile with a higher proportion of patients aged 65 years and over than those nationally (20% compared to 17%). There are 59% of patients with a long-standing health condition, higher than the national average of 54%.
Information published by Public Health England rates the level of deprivation within the practice population group as three on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest. Life expectancy for men in the area is approximately 78 years and for women approximately 82 years, lower than the national averages of 79 and 83 years respectively.
The practice clinical team is made up of six GP partners (four male, two female), one female salaried GP and two GP registrars. The practice also has a clinical pharmacist, three nurse prescribers and a health care assistant. Together with five other local practices, the practice also funded the appointment of a senior clinical pharmacist, shared between the practices. The practice administration team is led by the practice manager and a deputy practice manager assisted by two team leaders. The practice participates in the training of new GPs and is a teaching practice for medical students.
When the practice is closed, a telephone voicemail service directs patients to dial NHS 111 for advice and if necessary, onward referral to the out of hours service.
The practice is registered with CQC to provide family planning services, maternity and midwifery services, treatment of disease, disorder or injury, surgical procedures and diagnostic and screening procedures as their regulated activities.
Updated
29 November 2018
This practice is rated as Good overall. (Previous rating April 2017 – Good)
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 Tower House Practice on 30 October 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
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 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 a comprehensive system of meetings for staff at all levels. Governance of all areas of service delivery was embedded into practice.
- There was a clear management structure in place and staff had lead roles in all areas of practice service provision.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it. The practice took every opportunity to listen to patient views and concerns.
- There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice participated in the training of new GPs and was a teaching practice for medical students.
We saw an area of outstanding practice:
- The practice was proactive in taking every opportunity to work with patients, staff and external partners to shape and improve patient services. It had begun work with other local practices to standardise best practice across the local area and led on areas of this work. We saw examples of innovation in services such as the in-practice dermatology service which was to be adopted in the community by the clinical commissioning group. The practice also offered a sponsorship scheme for non-EU workers locally, allowing GPs to remain in the country who would otherwise have left.
The areas where the provider should make improvements are:
- Improve the protocol for the management of communications coming into the practice and introduce a GP audit of the process.
- Take steps to record action taken in response to patient safety medicines alerts in individual patient health records.
- Introduce a formal annual review of significant incidents in the practice.
- Review registers of those patients excluded from some areas of long-term condition monitoring.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.