Archived: Haddenham Surgery

Updated 31 March 2016

Haddenham Surgery is situated in Haddenham, Ely. The practice provides services for 7,217 patients. It holds a General Medical Services contract with Cambridgeshire and Peterborough CCG.

According to information taken from Public Health England, the patient population has an age profile which is comparable to the practice average across England. The practice is in an area with a low level of deprivation.

The practice team consists of a three male GP partners, two female GP partners, two male salaried GPs, a practice manager, four female practice nurses and a female healthcare assistant. The team also includes dispensary, secretarial and reception staff.

The practice is open from Monday to Friday. It offers GP and nurse appointments between 8:30am and 6.30pm Monday to Thursday, and 8.30am to 6pm on Fridays. It does not offer any extended hours clinics. The practice has a branch surgery in the neighbouring village of Stretham, which offers appointments between 10am and 11.30am Monday to Friday. Stretham Surgery was visited as part of this inspection.

Haddenham Surgery was inspected in May 2014 using previous CQC methodology, and was found to be compliant with the legal requirements and regulations associated with the Health and Social Care Act 2008. The practice did not receive a rating following this inspection under CQC’s previous methodology.

Updated 31 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Haddenham Surgery on 16 February 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 March 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management, and patients at risk of hospital admission were identified as a priority.
• The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2014/2015 showed that performance for diabetes related indicators was 83.7%, which was below the CCG average by 5.8% and below the national average by 5.5%. However, the practice had a very low level of exception reporting (exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).
• Longer appointments and home visits were available when needed.
• The practice offered in house anticoagulation monitoring services.
• Patients with long-term conditions had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• A community diabetic specialist nurse held weekly clinics at the practice.
• The practice had a robust recall system for annual health and medication reviews.

Updated 31 March 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.
• Immunisation rates were relatively high for all standard childhood immunisations.
• The practice ensured GPs carried out postnatal home visits or telephone calls for mothers of newborn babies.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 87%, which was above the CCG and England averages.
• The practice provided contraceptive and sexual health advice.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 31 March 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice rota ensured that there was a GP dedicated to doing home visits each morning.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure, were above local and national averages.

Updated 31 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years. The practice was able to refer patients to a health trainer to encourage lifestyle changes.

Updated 31 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 71% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is below to the national average.
• 81% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan, which was 5.8% below the CCG average and 7.1% below the England average. However, the exception reporting for this indicator was 0%, which was 15.2% below the CCG average and 12.6% below the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 31 March 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances, including those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice worked with the local travelling community, and had built up good relationships with these patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Patients who were carers were proactively identified and signposted to local carers’ groups.
• GPs carried out home visits for patients with palliative care needs.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.