This practice is rated as Good overall. (Previous inspection November 2015 – Good)

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 Hart Medical Practice on 4 April 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. However, communication about significant events did not always feed through the staff team.

• 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.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• 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.

• The practice was open and transparent, and had systems in place to adhere to the Duty of Candour.

• The practice displayed a strong commitment to multidisciplinary working and could evidence how this positively impacted on individual patient care.

• Discussion with staff and feedback from patients showed that staff were highly motivated to deliver care that was respectful, kind and caring.

• The practice organised and delivered their services to meet the needs of their patient population.They were proactive in understanding the needs of the different patient groups.

We saw areas of outstanding practice:

• The practice employed a medicines management team of three staff who dealt with all aspects of the patients medicines, working alongside the clinical commissioning group(CCG) pharmacist and technician . The team were available to patients, pharmacies, community staff and care homes. They were able to deal with queries or concerns they may have with their medication. The GP practice variation in spending (GVIS) showed that the practice was the lowest spend per patient head in Hartlepool.

  The practice offered a fast response for ‘poorly’ patients not on the palliative care register. Also for patients suffering from exacerbation of chronic obstructive pulmonary disease (COPD). Patients were offered open access to the practice where they were fully assessed and, if indicated, treated and monitored in the practice with nebulisers and oxygen.

The areas where the provider should make improvements are:

• Review and update the fire risk assessment.

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

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hart Medical Practice on <4 November 2015. 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 the skills, knowledge and experience to deliver effective care and treatment.
• 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 patients said they were able to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw two areas of outstanding practice:

• The practice offered a fast response for patients suffering from exacerbation of chronic obstructive pulmonary disease (COPD). Patients were offered open access to the practice were they were fully assessed and if indicated treated and monitored in the practice with nebulisers and oxygen if required. This process meant that patients were reassured and there was a reduction in admissions to hospital for exacerbation of COPD.

• The practice have employed a medicines management team of three staff who deal with all aspects of the patients medication working alongside the clinical commissioning group( CCG) pharmacist and technician . The team were available to patients, pharmacies, community staff and care homes. They were able to deal with queries or concerns they may have with their medication. Patients were positive about this service and the scheme has been shared and adopted by local practices.

The areas where the provider should make improvement are:

• Ensure the recruitment policy is followed

• Ensure there is a process in place to monitor staff training.

• Ensure information is securely stored in the consulting rooms.

• Ensure there are dates for review and follow up of actions following significant events.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice