Horizon Healthcare

Updated 18 December 2023

Horizon Healthcare is located in Derby at:

5 Burton Road

Derby

DE1 1TH

The practice has a branch practice at:

Humbleton Road Surgery

31 Humbleton Drive

Mackworth

Derby

DE22 4AU

We visited both of these practices as part of our inspection.

The provider is registered with CQC to deliver the Regulated Activities, diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures. These are delivered from both sites.

The practice is situated within the Joined Up Care Derbyshire Integrated Care System and delivers General Medical Services (GMS) to a patient population of about 21,800. This is part of a contract held with NHS England.

The practice is part of the Derby City North Primary Care Network (PCN), a wider network of 5 GP practices that work collaboratively to deliver primary care services.

Information published by the Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the second lowest decile (2 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 74.4% White, 16.7% Asian, 3.8% Black, 3.4% Mixed, and 1.7% Other.

The age distribution of the practice population demonstrates a lower proportion of older patients and a higher number of working age patients compared to local and national averages:

• The percentage of older people registered with the practice is 12.6% which is below the local average of 20.5% and the national average of 17.8%.
• The percentage of working age patients registered with the practice is 65.9% which is above the local average of 60.2% and the national average of 62.4%.

There is a team of 3 GP partners, 10 salaried GPs and 2 locum GPs who provide cover at both practices. The practice has a team of 2 practice nurses, a nurse associate and a trainee nursing associate, 3 clinical pharmacists, an advanced nurse practitioner (ACP), 3 locum ACPs and 3 community psychiatric nurses. Clinicians are supported at the practice by a team of reception and administration staff. The practice business manager, the practice business manager’s assistant, the CQC quality lead and the deputy manager provide managerial oversight.

The main practice is open between 8am to 6.30pm Monday to Friday. The branch practice is open between 8am to 4pm Monday and Wednesday to Friday. The practice offers a range of appointment types including face-to-face and telephone consultations which can be pre-booked or booked on the day. Patients can book appointments over the telephone or online.

Extended access is provided locally by Derby City North Primary Care Network, where late evening and weekend appointments are available. Out of hours services are provided by Derbyshire Health United (DHU).

Updated 18 December 2023

We carried out an announced comprehensive at Horizon Healthcare on 24 and 28 November 2023. Overall, the practice is rated as good. Due to assurances we received from our review of information, we carried forward the rating of good from our previous inspection in May 2016 for the key question caring. We rated the practice as good for providing safe, effective and well-led services and requires improvement for providing responsive services.

Following our previous inspection on 26 May 2016, the practice was rated good overall and for all key questions.

The full report for the previous inspection can be found by selecting the ‘all reports’ link for Horizon Healthcare on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

• We inspected the key questions safe, effective, responsive and well-led.

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.
• Completing remote clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patients’ records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit.
• Staff feedback forms.
• Speaking with a member of the Patient Participation Group.
• Speaking with representatives of 3 care homes where the practice provided care and treatment.

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 rated the practice as good for providing safe, effective and well-led services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• The practice learned and made improvements when things went wrong.
• Patients received effective care and treatment that met their needs.
• The indicators for childhood immunisation and cervical screening uptake rates were below national targets. Initiatives had been put in place to address this.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

However, we rated the practice as requires improvement for providing responsive services because:

• The results of the National GP Patient Survey showed that patient satisfaction with telephone access to appointments and overall experience of making an appointment was low. We recognise the pressure that practices are currently working under and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by people’s needs and experiences of care. Although we saw the practice was attempting to improve access, this was not yet reflected in the GP patient survey data. Therefore, the rating is requires improvement, as ratings depend on evidence of impact and must reflect the lived experience that people were reporting at the time of inspection.

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

• Take steps to obtain proof of immunity to hepatitis B for staff who had received vaccination to confirm they had acquired immunity.
• Clearly document when fire safety drills have taken place and the learning from them.
• Review their systems for acting on safety alerts such as Medicines and Healthcare Products Regulatory Agency (MHRA) alerts.
• Embed into practice formal systems to audit the prescribing of non-medical prescribers and support their competence through formal clinical supervision. Embed into practice revised systems for tracking prescription stationery throughout the practice.
• Continue to act upon the immunisation and cervical screening uptake rates and embed into practice the role of the cancer co-ordinator.
• Continue to monitor patient satisfaction with access to appointments and act on the feedback provided.

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 Health Care