We carried out an announced comprehensive inspection at Spring Hill Practice on 26 February 2019 as part of our inspection programme.

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 and outstanding for being well-led

We rated the practice as outstanding for providing well-led services because:

• The practice had taken over the contract from a large provider in October 2017. It soon became aware that a number of issues, including clinical reporting and attendant governance systems required substantial improvement. These governance and performance management arrangements were proactively reviewed and reflected best practice. It had worked extremely hard to improve these systems for the benefit of patients.
• Following the merger, it had had to cope with a number of issues, including: working with two computer systems and across two geographical sites; it had moved location twice, only moving to its present site in September 2018 which required it to operate from three separate locations across two buildings. This entailed a need for three sets of reception staff
• Despite these issues the practice had made significant improvements, including: recruitment and training of new staff; improved staff morale; the introduction of a fully revised appointments system that had greatly improved patient access; NHS Choices comments showed the practice had improved patient satisfaction with 4 out of 5 stars from 94 reviews, a significant improvement on NHS Choices comments compared to before the merger. Throughout this the practice had managed to maintain and improve its clinical performance in a number of areas, including significantly improved prescribing levels for antibacterial and Nonsteroidal anti-inflammatory (NSAIDs) medicines.

We found that:

• The practice took a proactive approach to reducing the number of antibacterial and Nonsteroidal anti-inflammatory drugs (NSAIDs) prescriptions it issued.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Continue to work to improve uptake of its childhood immunisations programme.
• Continue to work to improve uptake of its cervical and breast cancer screening programmes.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care