Background to this inspection
Updated
1 January 2020
Unity Health is a five site GP practice located across five towns and villages in Buckinghamshire and Oxfordshire. Unity Health was formed in October 2017 following the merger of two multi-site practices, has approximately 22,000 patients and is one of the practices within Buckinghamshire Clinical Commissioning Group (CCG).
Clinical services are provided from:
- Brill Surgery, 22 Thame Road, Brill, Aylesbury, Bucks HP18 9SA.
- Chinnor Surgery, 5 Station Road, Chinnor, Oxfordshire OX39 4PX.
- Long Crendon Surgery, New Chapel Surgery, High Street, Long Crendon, Aylesbury, Bucks HP18 9AF.
- Thame Health Centre, East Street, Thame, Oxfordshire OX9 3JX.
- Princes Risborough Surgery, Wades Field, Stratton Road, Princes Risborough Bucks HP27 9AX.
The practice website is:
We visited three of the five sites as part of this inspection – Princes Risborough Surgery (referred to as the main site) and both dispensing practices (Brill Surgery and Long Crendon Surgery).
Across the five sites, there are 10 Partners (nine GP Partners and one Managing Partner), 16 GPs, a pharmacist and a paramedic (sub contracted from the local ambulance service) at the practice. The nursing team consists of two advanced nurse practitioners, seven practice nurses and five health care assistants with a mix of skills and experience. One of the GPs is the designated dispensary lead and the combined dispensary team consists of seven dispensers.
The Managing Partner, practice manager and a team of reception and administrative staff undertake the day to day management and running of the practice.
According to national data there are high levels of affluence and minimal deprivation in Buckinghamshire and Oxfordshire, specifically the towns, villages and hamlets within Unity Health’s practices catchment areas. The practice population has a higher proportion of patients aged 65 and over when compared to the national average.
Extended hours appointments were available at all five sites with either a GP, nurse or health care assistant. The Brill Surgery offered evening appointments between 6.30pm and 8pm on alternate Tuesdays, Princes Risborough Surgery and Chinnor Surgery offered evening appointments between 6.30pm and 8.30pm on Tuesday, Wednesday and Thursday evenings on rotation, Thame Health Centre offered evening appointments between 6.30pm and 8pm on alternate Wednesdays and Long Crendon Surgery offered Saturday morning appointments between 8.30am and 10.30am. Patients at the practice could access improved access appointments at primary care access hubs across south Buckinghamshire. These improved access appointments were booked via the patient’s registered practice and offered a variety of appointments including up until 8pm Monday to Friday, selected hours on Saturdays and 9am until 1pm on Sunday and Bank Holidays. Furthermore, in addition to face to face GP appointments, patients could also access an in-sourced GP via secure video.
The dispensary has core opening hours between 9am and 6pm every weekday with the exception of Thursdays when the dispensary closes at 1pm.
The practice is registered by the Care Quality Commission (CQC) to carry out the following regulated activities: Maternity and midwifery services, Family planning, Treatment of disease, disorder or injury, Surgical procedures and Diagnostic and screening procedures.
Updated
1 January 2020
We carried out an announced focused inspection at Unity Health, a multi-site GP practice in Buckinghamshire and Oxfordshire on 27 November 2019 as part of our inspection programme.
We carried out an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions:
- Are services safe?
- Are services effective?
- Are services well-led?
Following assurance received from our review of information we carried forward the ratings for the following key questions from the previous inspection in October 2015 and April 2016:
- Are services caring?
- Are services responsive?
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 good overall. We rated the practice as good for providing safe and effective services and for the following population groups: older people; people with king term conditions, families children and young people; people whose circumstances may make them vulnerable and people experiencing poor mental health (including dementia).
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- The practice had comprehensive systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service 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.
We rated the practice as
outstanding
for providing well-led services because:
- There was compassionate, inclusive and effective leadership at all levels. Leaders at all levels demonstrate the high levels of experience, capacity and capability needed to deliver excellent and sustainable care. This included the management of the merger of two multi-site practices into one large practice, covering two counties with approximately 21,750 patients across five sites.
- Despite service delivery from five separate sites, there was collaboration, team-working and support across all functions and a common focus on improving the quality and sustainability of care and people’s experiences.
- There was a fully embedded and systematic approach to improvement, which made consistent use of a recognised improvement methodology. Improvement was seen as the way to drive performance and for the organisation to learn. There was a clear, systematic and proactive approach to seeking out and embedding new and more sustainable models of care which was shared locally and nationally.
The areas where the provider
should
make improvements:
- Continue to develop the cold chain processes for all medicines which require refrigeration.
- Develop the processes within the dispensaries to audit compliance and adherence to standard operating procedures. This would include how the practice assess individual competency and increase awareness of the role of the NHS Regional Lead Controlled Drugs Accountable Officer (CDAO).
Details of our findings and the evidence supporting the change in rating are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care