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Review carried out on 29 August 2019

During an annual regulatory review

We reviewed the information available to us about The Heavitree Practice on 29 August 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 17 March 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Heavitree Practice on 17 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • The practice was part of a pilot site for a pre-diabetic education project overseen by a local charity. The aim was to support patients and provide lifestyle education for patients recently diagnosed with or at risk of developing type two diabetes.
  • The practice had been part of 11 clinical research projects over the last two years. A current project involved identifying patients who may benefit from targeted exercises following a stroke to improve recovery.
  • Information about patients’ outcomes was used to make improvements; such as identifying patients with osteoporotic vertebral fracture as part of a pilot research project and then offering these patients focused physiotherapy rehabilitation courses.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • The practice informed vulnerable patients about how to access various support groups and voluntary organisations. For example, the practice benefitted from support services provided by the Friends of Heavitree Health Centre charity, which provided volunteer transport services for patients to secondary care health appointments.
  • The Friends of Heavitree Health Centre charity, based within the practice, also offered Tai Chi classes, shopping trips and social activities, which had reduced social isolation of vulnerable patients.
  • Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice offered pre-bookable early morning appointments from 7.40am on three mornings a week and evening appointments until 7.30pm on alternate Thursdays for working patients who could not attend during normal opening hours.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
  • The practice worked in partnership with a local charity offering work placements to people who had learning disabilities and/or long term health conditions. Staff told us this helped them learn about the health and wellbeing needs for patients in the wider community and those registered at the practice with similar conditions.
  • The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

  • The practice was an early initiator of the implementation of the NHS accessible information standard, which organisations must follow by 31 July 2016. The standard was intended to ensure that patients who have a disability, impairment or sensory loss get information that they can access and understand, and receive any communication support that they need. The practice had ensured progress by ensuring that the accessible information standard was discussed at all patient participation group, practice whole team and Exeter practice managers’ meetings.

The areas where the provider should make improvement are:

  • Include emergency medical equipment instructions in trainee GP staff induction sessions.
  • The practice should continue to review prescription pad security to ensure new processes are followed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice