Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Handbridge Medical Centre on 2nd February 2016.

Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Staff were aware of procedures for safeguarding patients from the risk of abuse.
• There were systems in place to reduce risks to patient safety, for example, infection control procedures and the management of staffing levels.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff felt well supported. They had access to training and development opportunities and had received training appropriate to their roles.

• Patients were very positive about the care they received from the practice. They commented that they were treated with respect and dignity and that staff were caring, supportive and helpful.

• Services were planned and delivered to take into account the needs of different patient groups.

• Access to the service was monitored to ensure it met the needs of patients. Patients reported satisfaction with opening hours and said they were able to get an appointment when one was needed.

• Information about how to complain was available. There was a system in place to manage complaints.

• There were systems in place to monitor and improve quality and identify risk.

We saw areas of outstanding practice:

• The practice had developed and recently implemented its own autism protocol. This acted as an aide memoire to staff when booking appointments for patients with suspected or diagnosed autism and suggested reasonable adjustments to be made when attending the practice. It also stressed the importance of good communication with patients and their families or carers.

• The practice website had a page specifically for young people which included information on common health questions, sexual health and smoking. This also provided reassurances about confidentiality which encouraged young people to visit the GP about their health concerns. The practice had also adopted the “Zoe” system after reading about how this had been implemented at another practice. This allowed a young person to make an appointment without having to go through a triage process which encouraged them to make appointments about issues they may find it difficult to talk about.

• Following an audit a new role had been developed for a nurse in the management of coeliac disease. This was to ensure that these patients received a range of annual health checks, vaccinations and dietary advice. The nurse referred the patient to the GP if any issues were identified. A follow up coeliac audit 2015-2016 indicated that most patients were taking up their invitation to be seen annually for checks and vaccinations.

The areas where the provider should make improvements are:

• A record should be made of which clinician printable prescriptions have been allocated to as recommended by NHS Protect.

• A risk assessment of the storage of printable prescriptions and written patient records should be undertaken to ensure these are securely stored at all times.

• A disability access audit of the premises should be undertaken.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The Handbridge Medical Centre is located in Handbridge, in the City of Chester. It provides a range of services for all population groups across all ages. People can access advice, care and treatment by telephone consultations with doctors or nurses and book appointments online or by phone. Usual opening times are 8am to 6.30pm Monday to Friday. The practice was registered by the Care Quality Commission (CQC) in April 2013 to provide the following regulated activities:

Treatment of disease, disorder or injury

Surgical procedures

Maternity and midwifery services

Family planning

Diagnostic and screening procedures.

All the patients we spoke with were complimentary about the service they received. We saw the latest patient survey results, which showed patients were consistently pleased with the service. We received a number of comments cards that had collected the views of patients at the practice over the previous two weeks before our inspection. All the comments received were extremely positive about care, treatment and services provided by the Handbridge Medical Centre.

The practice delivered services safely. We found that safeguarding of adults and children was managed well. All staff had been trained at a level appropriate to their role and demonstrated knowledge, application and understanding of safeguarding.

The practice was effective in how it delivered care and treatment. We saw examples of good practice, including care for people aged over 75 and an award won for innovative practice in community mental health care.

The practice was responsive to the needs of its patient population. Members of the patient participation group (PPG) told us how the practice responded well and made improvements to services following suggestions, comments or complaints.

We found the practice to be extremely well-led. There was an open culture of incident reporting and learning from events and complaints to improve services. There were excellent arrangements for governance and managing risks, which ensured patients were cared for and treated safely and effectively.

The practice provided services for all population groups safely, effectively and in a caring, responsive manner. A number of services were developed for specific population groups. These were delivered effectively in line with current good practice guidelines.

We reviewed the information available to us about The Handbridge Medical Centre on 12 June 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.