Kington Medical Practice

Updated 9 December 2022

Kington Medical Practice is located in the Kington area of Hereford. The practice provides a dispensary service allowing patients to collect their medicines from the dispensary which is also based at the same health centre as the practice.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

The practice is situated within the NHS Herefordshire and Worcestershire Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 7300. This is part of a contract held with NHS England.

The practice is part of a Primary Care Network called Taurus Healthcare. Taurus Healthcare operates as a GP federation which is owned by all of the General Practices in Herefordshire and is run by them. The federation manages three primary care hubs which offer local GP and nurse extended hours services to patients from across the county.

There is a team of 5 GPs and a team of 4 nurses 1 pharmacist. The GPs are supported at the practice by a team of reception/administration staff. The practice manager and assistant practice manager are based at the main location to provide managerial oversight.

Information published by Public Health England shows that deprivation within the practice population group is in the fifth decile (5 of 10) with one being most deprived and 10 being least deprived. The practices patients are mostly within the older and working-aged groups. According

to the latest available data, the ethnic make-up of the practice area is 1% Asian and 99% White.

The practice is open between 8.30am to 6.00pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Patients can access appointments on evenings and weekends by visiting any of the six listed hub locations in Herefordshire: South Wye Medical Centre, The Marches Surgery, Pendeen Surgery, Ledbury Health Partnership, Nunwell Surgery, and appointments are available at Kington Medical Practice on Sundays and some bank holidays as part of this arrangement. These appointments are offered through Taurus Healthcare. In addition, when the practice is closed patients are directed to the GP out of hours service which is accessed through the NHS 111 service.

Updated 9 December 2022

We carried out an announced focused inspection at Kington Medical Practice on 4 November 2022 Overall, the practice is rated as good.

Safe - not inspected

Effective - not inspected

Caring - not inspected

Responsive - not inspected

Well-led - good

Following our previous inspection on 4 February 2022, the practice was rated good overall and for all key questions but requires improvement for providing well led services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Kington Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection. Therefore as part of this focused inspection we inspected the well led question to follow up on the previous breach requiring the practice to establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. In addition we also reviewed the practices efforts to engage with patients and encourage attendance at cervical screening appointments as well as their current work in the recording and reflecting on positive outcomes following quality improvement initiatives and clinical audits. This inspection included a comprehensive review of information and a remote interviews with staff working at the practice.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included

• Conducting staff interviews using video conferencing.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.

Our findings

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 found that:

• At this inspection, we found that systems for monitoring and acting on safety alerts had been strengthened. Additional support systems were in place to ensure staff were competent to carry out their roles.
• The practice had a clear vision and credible strategy to provide high quality sustainable care. They used a business plan to identify challenges and aimed to improve quality of care.
• Data published by UK Health Security Agency for 22 June 2022 for the percentage of persons eligible for cervical cancer screening were screened adequately within a specified period (within 3.5 years for persons aged 25 to 49, and within 5.5 years for persons aged 50 to 64) remained under national targets. The practice continued to encourage patients to attend screening appointments and offered additional appointments on weekends and outside of work house. Female sample takers were available and systems were in place to call and recall patients who had not attended their cervical screening appointments. Unverified data sent by the practice 5 November 2022 showed 73% persons aged 25 to 49 and 82% of persons aged 50 to 64 had attended their appointments.
• Formal employee immunisation process and guidance systems were not in place at the time of the inspection. In particular, there was no standard working procedures in place related to the immunisation of staff. In addition there were members of staff working without up to date immunisations or risk assessments to mitigate risk to themselves and patients whilst working unvaccinated.

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

• Continue with efforts to engage with patients and encourage attendance at cervical screening appointments.
• Take action to improve the employee immunisation programme or you could say Take steps to evidence that an effective employee immunisation programme is in place.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services