Archived: Harden Surgery

Updated 9 March 2018

Phoenix Primary Care Limited (which is a subsidiary of The Practice Group) is registered with the Care Quality Commission (CQC) as an organisation with primary care services across the country. Harden Surgery (which is part of Phoenix Primary Care Limited) is located in Walsall, West Midlands. The practice is part of the NHS Walsall Clinical Commissioning Group. The practice holds an Alternative Provider Medical Services (APMS) contract with NHS England. An APMS contract is a contract between NHS England and general practices for delivering general medical services with a number of additional services. The contract is time limited.

The practice operates from Harden Surgery, Harden Health Centre, Harden Road, Bloxwich, Walsall, West Midlands, WS3 1ET.

There are approximately 2,735 patients of various ages registered and cared for at the practice. Demographically the practice has a higher than average patient population aged under 18 years, with 30% falling into this category, compared with the CCG average of 24% and England average of 21%. Nine per cent of the practice population is above 65 years which is considerably lower than the CCG average of 16% and the national average of 17%. The percentage of patients with a long-standing health condition (58%) is comparable to the local CCG average of 56% and national average of 54%. The practice provides GP services in an area considered as one of the most deprived within its locality. Deprivation covers a broad range of issues and refers to unmet needs caused by a lack of resources of all kinds, not just financial.

The staffing consists of:

• Five part time GPs (three male and two female).
• A part time advanced nurse practitioner, part time practice nurse and full time health care assistant (all female).
• A practice manager, practice administrator, secretary and reception staff.

The practice is open between 8am and 8pm Monday and Tuesday, 8am and 1pm Wednesday, 8am until 6.30pm Thursday and Friday, and 9am until 12 noon on Saturday. Extended hours consultations are available on Monday and Tuesday evenings and Saturday mornings.

The practice does not routinely provide an out-of-hours service to their own patients but patients are directed to the out of hours service, via the NHS 111 service when the practice is closed.

The practice offers a range of services for example: management on long term conditions, child development checks and childhood immunisations, contraceptive and sexual health advice. Further details can be found by accessing the practice’s website at www.hardensurgery.nhs.uk.

Updated 9 March 2018

We previously carried out an announced comprehensive inspection at Harden Surgery on 5 September 2016. The overall rating for the practice was Requires Improvement. This was because systems were not in place to investigate and learn from significant events, the management of safety alerts was not effective and the lack of some of the suggested emergency medicines had not been risk assessed.

We undertook an announced focused inspection on 23 May 2017 to follow up on the requirement notices. We looked at whether Harden Surgery was providing safe, effective and well led services. We continued to rate the practice as Requires Improvement overall. However we found not all of the necessary improvements had been made and we rated the practice as inadequate for providing well led services. This was because there were insufficient staff to meet the needs of patients and the governance arrangements were ineffective.

Both the full comprehensive report on the September 2016 and the focused inspection on 23 May 2017 can be found by selecting the ‘all reports’ link for Harden Surgery on our website at www.cqc.org.uk

This inspection was an announced comprehensive inspection carried out on 8 February 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 23 May 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection

This practice is rated as Good overall.

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

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

At this inspection we found:

• Improvements had been made in the clinical leadership and capacity. A team of regular locum GPs worked at the practice providing continuity of care for patients. The practice management had been strengthened by the appointment of a new practice manager.
• There was a clear leadership structure and staff felt supported by management. Staff told us they were now able to raise concerns, were encouraged to do so and had confidence that these would be addressed.
• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learnt from them and improved their processes. Improvements had been made and information and learning from significant events was discussed at clinical and practice meetings.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• The practice worked closely with other health and social care professionals involved in patient’s care. Regular meetings had been re-established with the community nursing teams and palliative care teams to discuss the care of patients who were frail / vulnerable or who were receiving end of life care.
• The practice had carried out clinical audits to review the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines. The audits seen demonstrated quality improvements.
• Patients commented that they were treated with compassion, kindness, dignity and respect.
• We found that the scores for GPs and nurses in the GP Patient Survey published July 2017 were comparable to the local averages. A number of the satisfaction scores relating to access were lower than the local averages. The practice had reviewed these scores and taken action to address them. For example a new telephone system had been installed and the number of GP appointments had increased.
• Information about services and how to complain was available.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were also areas of practice where the provider should make improvements.

• Continue to develop the carers’ register.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 March 2018

Updated 9 March 2018

Updated 9 March 2018

Updated 9 March 2018

Updated 9 March 2018

Updated 9 March 2018