Lincoln House Surgery

Updated 17 March 2017

Lincoln House Surgery provides a range of primary medical services from its premises at 163 London Road, Hemel Hempstead, Hertfordshire, HP3 9SQ.

The practice serves a population of approximately 12,379. The area served is less deprived compared to England as a whole. The practice population is predominantly white British. The practice serves an above average population of those aged from 25 to 34 years and 45 to 59 years. There is a lower than average population of those aged from 0 to 24 years.

The clinical team includes three male and two female GP partners, two female salaried GPs, three practice nurses and one healthcare assistant. The team is supported by a practice manager, a reception manager and 12 other administration, reception and secretarial staff. The practice provides services under a General Medical Services (GMS) contract (a nationally agreed contract with NHS England).

The practice is fully open (phones and doors) from 8.30am to 6.30pm Monday to Friday. There is extended opening from 7am every Monday and Tuesday and until 7.30pm once a week on a Monday or Tuesday in rotation. There is extended opening one Saturday each month from 9am to 11am for GP and nurse pre-bookable appointments. Appointments are available from approximately 8.30am to 11.30am and 2pm to 4.30pm or 3.30pm to 6pm daily, with slight variations depending on the doctor and the nature of the appointment.

An out of hours service for when the practice is closed is provided by Herts Urgent Care.

Updated 17 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lincoln House Surgery on 5 April 2016. The overall rating for the practice was requires improvement. The full comprehensive report from the 5 April 2016 inspection can be found by selecting the ‘all reports’ link for Lincoln House Surgery on our website at www.cqc.org.uk.

After the comprehensive inspection, the practice wrote to us and submitted an action plan outlining the actions they would take to meet legal requirements in relation to;

• Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 - safe care and treatment.
• Regulation 17 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 - good governance.
• Regulation 18 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 - staffing.

The areas identified as requiring improvement during our inspection in April 2016 were as follows:

• Ensure an appropriate system was in place for the safe use and management of medicines, medical consumables and prescriptions, including those used in an emergency.
• Ensure a plan of action to control and resolve risks identified by the Legionella risk assessment was completed. (Legionella is a term for a particular bacterium which can contaminate water systems in buildings).
• Ensure that a comprehensive business continuity plan was in place so that a service could be maintained in the event of a major incident.
• Ensure that staff who act as chaperones were appropriately trained.
• Ensure that all staff employed were receiving appropriate supervision and appraisal.

In addition, we told the provider they should:

• Ensure that all staff completed a formal programme of infection control training.
• Take steps to ensure that in future National GP Patient Surveys the practice’s areas of below local and national average performance were improved.
• Take steps to improve access to the practice by telephone.
• Continue to identify and support carers in its patient population.

We carried out an announced focused inspection on 14 December 2016 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 5 April 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key finding on this focused inspection was that the practice had made improvements since our previous inspection and were now meeting regulations that had previously been breached.

Overall the practice is now rated as good.

On this inspection we found:

• There were appropriate arrangements in place for the safe use and management of medicines, including emergency medicines, vaccines and medical consumables.
• Blank prescription forms and pads were securely stored and there were systems in place to monitor their use.
• Appropriate Legionella management processes were in place.
• Arrangements were in place to respond to emergencies and major incidents.
• Staff who acted as chaperones were appropriately trained for the role.
• A programme was in place to ensure all staff received an appraisal on an annual basis.

Additionally where we previously told the practice they should make improvements our key findings were as follows:

• A programme of infection control training was in place and all staff had completed this.
• The practice discussed their below average satisfaction scores from the National GP Patient Survey published in January 2016. They demonstrated they had taken action to improve these including reducing the administration and managerial workload of the GPs and increasing the amount of patients accessing their online facilities such as appointment booking. The results from the National GP Patient Survey published in July 2016 showed improvement in all the areas previously of concern. The practice was now mostly performing in line with local and national averages. Senior staff at the practice were aware of any current areas of below average satisfaction scores and could demonstrate they were responding to it.
• Through additional training for some staff and a targeted approach the practice had increased the amount of carers identified in its patient population. As of December 2016 the practice had identified 145 patients on the practice list as carers. This was approximately 1.2% of the practice’s patient list and was an increase of around 48% from our inspection in April 2016.

Following our inspection on 14 December 2016 the area where the provider should continue to make improvement is:

• Ensure that all non-clinical staff are supported by receiving appropriate supervision and appraisal.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 March 2017

At our focused inspection on 14 December 2016 we found the provider had resolved the concerns we identified under safe, effective and well-led services at our comprehensive inspection on 5 April 2016. This applied to everyone using the practice, including this population group. The population group ratings have been updated to reflect this.

Updated 17 March 2017

At our focused inspection on 14 December 2016 we found the provider had resolved the concerns we identified under safe, effective and well-led services at our comprehensive inspection on 5 April 2016. This applied to everyone using the practice, including this population group. The population group ratings have been updated to reflect this.

Updated 17 March 2017

At our focused inspection on 14 December 2016 we found the provider had resolved the concerns we identified under safe, effective and well-led services at our comprehensive inspection on 5 April 2016. This applied to everyone using the practice, including this population group. The population group ratings have been updated to reflect this.

Updated 17 March 2017

At our focused inspection on 14 December 2016 we found the provider had resolved the concerns we identified under safe, effective and well-led services at our comprehensive inspection on 5 April 2016. This applied to everyone using the practice, including this population group. The population group ratings have been updated to reflect this.

Updated 17 March 2017

At our focused inspection on 14 December 2016 we found the provider had resolved the concerns we identified under safe, effective and well-led services at our comprehensive inspection on 5 April 2016. This applied to everyone using the practice, including this population group. The population group ratings have been updated to reflect this.

Updated 17 March 2017

At our focused inspection on 14 December 2016 we found the provider had resolved the concerns we identified under safe, effective and well-led services at our comprehensive inspection on 5 April 2016. This applied to everyone using the practice, including this population group. The population group ratings have been updated to reflect this.