Background to this inspection
Updated
22 August 2018
Highgate surgery is located at the Grimethorpe Centre, Acorn Way, Barnsley, S72 7NZ.The practice provides alternative provider medical services (APMS) under a contract with NHS England for 3,518 patients in the NHS Barnsley Clinical Commissioning Group (CCG) area.
The service is provided by Barnsley Healthcare Federation CIC who have four GP practice locations, two extended hours centres and one out of hours services registered with the Care Quality Commission.
The provider's head office is based at Oaks Park Primary Care Centre in Barnsley. Staffing and governance systems are centrally operated from head office and cascaded to the individual locations. Staff at Highgate surgery had access and support from the senior management team at the head office.
The surgery has a branch :-
Shafton Surgery
Unit 5
Two Gates Way
High Street
Shafton
Barnsley
S72 8WL
Public Health England data shows the practice population is similar to others in the CCG area with a comparable number of patients aged over 50 years old compared to the England average. BHF Highgate Surgery is situated in Grimethorpe on the outskirts of the Barnsley. The practice catchment area has been identified as one of the most deprived areas nationally.
Allocated to BHF Highgate Surgery and Shafton branch are three male salaried GPs, two practice nurses, one healthcare assistant, one physician associate (support doctors in the diagnosis and management of patients. They are trained to perform a number of roles including: taking medical histories, performing examinations, analysing test results, and diagnosing illnesses under the direct supervision of a doctor) and an experienced team of reception and administration staff.
The practice website is www.highgatesurgery.co.uk
When the practice is closed or patients are unable to access an appointment, staff refer patients to the i-heart Barnsley 365. This service is open from 6pm to10pm Monday to Friday and 9am to 1pm on Saturday, Sunday and bank holidays.
The service offers urgent and routine appointments, telephone and email consultations with a nurse or GP. During the out of hour’s period the patients call NHS 111, who direct them to the most appropriate service.
Updated
22 August 2018
This practice is rated as requires improvement overall.
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Requires improvement
Are services well-led? – Requires improvement
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Requires Improvement
People with long-term conditions – Requires Improvement
Families, children and young people – Requires Improvement
Working age people (including those retired and students – Requires Improvement
People whose circumstances may make them vulnerable – Requires Improvement
People experiencing poor mental health (including people living with dementia) - Requires Improvement
We carried out an announced inspection at Barnsley Healthcare Federation, Highgate Surgery on 6 March 2018 as part of our inspection programme. We also carried out an announced comprehensive inspection at Barnsley Healthcare Federation CIC head office based at Oaks Park Medical Centre on 13 and 14 February 2018 to look at governance as part of our inspection programme.
At this inspection we found:
- There was no open and transparent approach to safety and no effective system in place for recording, reporting and learning from significant events.
- The practice did not routinely review the effectiveness and appropriateness of the care it provided. There was limited evidence of audits and quality improvement activities to demonstrate monitoring and assessment of the patient outcomes was being undertaken since the service registered in July 2016.
- We saw minimal evidence of mechanisms for recording actions taken in relation to best practice guidance.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients told us through CQC questionnaires, that they felt listened to and supported by staff and had sufficient time during consultations to make an informed decision about the choice of treatment available to them.
- There was a lack of overarching governance arrangements in place that meant patients were not always kept safe from avoidable harm.
- There was a leadership structure but communication between staff and management needed improvement and some staff felt unsupported by the senior management team.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure governance arrangements are in place to keep patients safe from avoidable harm.
- Ensure that there is an accessible system for identifying, handling. Investigating and responding to complaints made about the service.
- Ensure individual care records are written and managed in a way that keep patients safe
The areas where the provider should make improvements are:
- Consider a centralised practice induction pack is available for all staff and clinicians who may not be completely familiar or up to date with practice processes.
- Consider a lone working policy.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice