• Doctor
  • GP practice

Drs Hart, Heighton, Prakash Koteeswaran & Do

Overall: Good

Howdale Surgery, 48 Howdale Road, Downham Market, Norfolk, PE38 9AF (01366) 383405

Provided and run by:
Drs Hart, Heighton, Prakash Koteeswaran & Do

Latest inspection summary

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Background to this inspection

Updated 13 August 2018

Drs Hart, Heighton, Prakash Koteeswaran & Do, also known as Howdale Surgery is situated in Downham Market, Norfolk. The practice is situated in the NHS West Norfolk CCG area. The practice has a General Medical Services (GMS) contract with the NHS. There are approximately 7,146 patients registered at the practice. There is a main practice located in Downham Market and a branch practice located in Marham; both practices have dispensaries. The practice is able to offer dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy.

The practice team consists of four GP partners who hold financial and managerial responsibility for the practice and two salaried GPs (four male and two female). One GP is designated as the senior partner. The GPs are supported by three practice nurses and three health care assistants. There is a practice manager, a team of receptionists, a dispensary team and a number of support staff who undertake various duties.

The main practice is open between 8am to 6.30pm Monday to Friday apart from Wednesday where the practice closes at 12.30pm. The branch surgery is open between 8.30am and 12.30pm Monday to Friday and 4.30pm and 6.30pm on Mondays, Wednesdays and Fridays. Outside of practice opening hours a service is provided by another health care provider, IC24 via the 111 service. Extended hours are available at the main practice in Downham Market between 6.30pm and 7.45pm every Monday and between 6.30pm and 7.45pm on alternate Wednesdays at the branch practice in Marham.

According to Public Health England information, the patient population aged 0 to 4 is below the practice average across England and it has an above average number of patients aged 65 and over compared to the practice average across England. Income deprivation affecting children and older people is below the practice average across England.

Overall inspection


Updated 13 August 2018

This practice is rated as Good overall. At the previous inspection in February 2016 the

practice were 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

We carried out an announced comprehensive inspection at Drs Hart, Heighton, Prakash Koteeswaran & Do on 5 July 2018 as part of our inspection programme.

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 their processes.
  • Arrangements for dispensing medicines at the practice kept patients safe.
  • 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.
  • The practice’s performance in relation to the Quality Outcome Framework (QOF) results was generally in line with the Clinical Commissioning Group (CCG) and national averages.
  • Staff encouraged and supported patients to be involved in monitoring and managing their own health, for example through social prescribing schemes.
  • All GPs triaged telephone calls from 8.30am to 9am each morning. Patients spoke to a GP who assessed their call and gave advice, or arranged an appointment or home visit. The practice found this made effective use of the appointments available.
  • Results from the July 2017 national GP patient survey were generally in line with or above local and national averages and this was in line with comments received from patients during the inspection.
  • The complaint policy and procedures were in line with recognised guidance; however, not all verbal complaints were recorded.
  • Staff told us they were happy to work at the practice and felt supported by the management team. Staff told us they were encouraged to raise concerns and share their views.

The areas where the provider should make improvements are:

  • Implement and embed a system and process for recording and reviewing verbal complaints to encourage improvements.
  • Continue to improve the uptake of childhood immunisations.
  • Continue to improve the uptake of learning disability health checks.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice