Background to this inspection
Updated
19 March 2020
Hathaway Medical Partnership, Middlefield Road, Chippenham, Wiltshire, SN14 6GT is located within the Wiltshire local authority and is one of 46 practices serving the NHS Wiltshire Clinical Commissioning Group (CCG) area.
In 2007 the practice relocated from the site currently occupied by its branch practice, to the Hathaway Medical Centre. This is a large purpose-built building housing the medical practice and in which there are sub-let clinical areas including two dental suites, a surgical suite and a suite of private consulting rooms.
The large reception area is divided into zones that are colour coded for triaging. Patients are directed to zones for minor illnesses, ‘on the day’ appointments, and for pre-booked appointments with a nurse practitioner or GP.
Clinical assessment and consulting rooms are on the ground floor. Also on the ground floor is a large room for medical administration, a room for the medical secretaries and an IT room. On the first floor there is a call handling room containing positions for 7 telephone operators.
The Hathaway Medical Partnership is the main site and there is a local branch practice just over one mile away at 32 New Road, Chippenham, Wiltshire SN15 1HP. The branch practice was not inspected during this inspection.
Hathaway Medical Partnership provides general medical services to approximately 15,500 patients and has a higher proportion of registered patients (62.2%) who are of working age when compared to the CCG average of 57% but a comparable proportion when compared to the national average of 62%. It has a lower percentage (16.4%) of elderly patients over 65 years of age when compared to the local average of 23.1%.
Information published by Public Health England rates the level of deprivation within the practice population group as eighth on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
The practice is led by three male GP partners and three female GP Partners who are contracted to provide medical services under a Personal Medical Services (PMS). PMS contracts offer local flexibility compared to the nationally negotiated General Medical Services (GMS) contracts by offering variation in the range of services which may be provided by the practice, the financial arrangements for those services and the provider structure. They are also registered with the CQC for the following regulated activities: diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
The partners are supported by six salaried GPs, three paramedic practitioners, two advanced nurse practitioners, six practice nurses and five healthcare assistants (HCAs).
For non-clinical activities, the partners are supported by two practice managers, an operations manager, and 31 additional admin and reception staff.
Out of hour’s services are provided by NHS 111 whose contact details are available in the practice and on the website.
Updated
19 March 2020
We carried out an announced focussed inspection at Hathaway Medical Partnership on 15 January 2020 following our annual review of the information available to us which indicated that there may have been a significant change (either deterioration or improvement) to the quality of care provided since the last inspection in September 2016.
This inspection focused on the following key questions:
- Are services effective?
- Are services responsive?
- Are services well led?
Because of the assurance received from our review of information, we carried forward the ratings for the following key questions:
- Are services safe? (Good)
- Are services caring? (Good)
At our last inspection in September 2016, although there were no breaches in regulations, we noted that there were areas in which the practice should make improvements. At this inspection, we saw evidence that these areas had been addressed and improvements made.
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 rated the practice as requires improvement for the population groups containing people with long-term conditions, working age people (including those recently retired and students) and people experiencing poor mental health (including people with dementia) and for providing effective services because:
- Although the practice performed well in many benchmarking results (QOF), we found that there was high exception reporting and low achievement figures in the population groups affecting people with long-term conditions, working age people (including those recently retired and students) and people experiencing poor mental health. In relation to these, the practice was unable to fully demonstrate that enough improvements had been made.
We have rated this practice as good overall, good for providing responsive and well led services and good for the population groups containing older people and families, children and young people and people whose circumstances may make them vulnerable because:
- Patients’ needs were assessed, and care and treatment was delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
- The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
- Staff had the skills, knowledge and experience to deliver effective care, support and treatment.
- Staff worked together and with other organisations to deliver effective care and treatment.
- There was compassionate, inclusive and effective leadership at all levels. This included working with and supporting the PPG.
- The practice had a clear vision and set of values that prioritised quality and sustainability.
- The practice had a culture that drove high quality sustainable care.
- There were clear responsibilities, roles and systems of accountability to support good governance and management.
- There were clear and effective processes for managing risks, issues and performance.
Although we did not find any beaches of regulation on this inspection, we did see areas where the provider should make improvements. These are:
- Continue to monitor exception reporting rates to ensure they are applied accurately and in line with guidance.
- Continue improving the uptake of dementia reviews.
- Continue to review arrangements to improve the uptake of cervical screening.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care