The Taverham Partnership - Care Quality Commission

Background to this inspection

Updated 7 December 2017

The Taverham Partnership provides services to approximately 8,600 registered patients in a semi-rural area on the outskirts of Norwich. The practice is run by two male GP partners who are supported by two salaried GPs (one male and one female) and practice manager. One of the salaried GPs was planning to become a partner in December 2017. The practice employs one advance nurse practitioners who work closely with the GPs, three practice nurses and two healthcare assistants. Other support staff include two administrators, two secretaries, ten receptionists, a pharmacist three days per week and two dispensary staff. The practice is able to offer dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. The practice holds a general medical services contract with NHS England.

The practice is open between 8.30am and 6pm Monday to Friday. Extended hours appointments are offered on Tuesday evenings from 6pm to 7.30pm. Between the hours of 8-8.30am and 6-6.30pm calls are diverted to Medicom, run by the East of England Ambulance service. Patients are required to book these appointments in advance. In addition to pre-bookable, appointments can be booked up to three months in advance with a nurse and one month in advance with a GP. Urgent appointments are also available for people that need them, as well as telephone appointments. Online appointments are available up to one month in advance.

When the practice is closed patients are automatically diverted to the GP out of hour’s service provided by IC24. Patients can also access advice via the NHS 111 service.

We reviewed the most recent data available to us from Public Health England which showed the practice has a smaller number of patients aged 20 to 39 years old compared with the national average. It has a larger number of patients aged 45 to54 compared to the national average. Income deprivation affecting children is 9%, which is lower than the CCG average of 23% and national average of 20%. Income deprivation affecting older people is 10%, which is lower than the CCG average of 17% and national average of 16%. Life expectancy for patients at the practice is 80 years for males and 81 years for females; this is comparable to the CCG and England expectancy which is 79 years and 83 years.

Overall inspection

Good

Updated 7 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Taverham Partnership on 12 April 2017. The overall rating for the practice was requires improvement, with requires improvement for providing safe, caring and well led services. The practice was rated as good for providing effective and responsive services. The full comprehensive report on the 12 April 2017 inspection can be found by selecting the ‘all reports’ link for the Taverham Partnership on our website at www.cqc.org.uk.

We undertook a focussed follow up inspection on 16 November 2017 to check they had followed their action plan and to confirm they now met legal requirements in relation to the breaches identified in our previous inspection on 12 April 2017. This report only covers our findings in relation to those requirements.

Overall the practice is now rated as good overall, and good for providing safe, caring and well led services.

Our key findings from this inspection were as follows:

There was a fire risk assessment and action plan in place.
The system for reporting, recording and learning from significant events had improved.
There was an infection prevention and control audit in place with associated action plan. The lead was trained for the role.
Staff had been provided with a forum for feedback and management were taking actions on identified issues. There was evidence of improved governance arrangements.
The standard operating procedures for the dispensary were detailed enough to assure safety.
Improvements had been made to the overall patient satisfaction outcomes on the GP patient survey, published in July 2017. The practice had recorded 75 patients as carers (approximately 0.7% of the practice list) and had thoroughly reviewed the system for identifying and offering carers support.
Electrical equipment was calibrated and tested appropriately.
The system for identifying patients and the coding of their medical records, particularly those with diabetes, had been reviewed. The staff were now using a system for the scanning and coding of letters to ensure patients records were coded correctly. The GPs were aware that poor coding was identified at our previous inspection. They had reviewed the patients with diabetes to ensure those- patients with diabetes that had been expected had been coded correctly.
The system for managing complaints had been improved. The practice monitored and recorded verbal complaints in order to identify any trends. The practice shared learning from complaints at meetings and we saw minutes of meetings to confirm this. The practice had a system in place to ensure the closure of complaints.
There was a child oxygen mask available in the emergency equipment.

The areas where the provider should make improvement are:

Continue to identify and offer support to carers.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice