Background to this inspection
Updated
6 September 2019
- Needham Market Country Practice is situated on the outskirts of Needham Market, Suffolk and provides General Medical Services to approximately 12,500 patients. The practice is in a rural area and, for those patients who prefer or without transport, the practice offers appointments in the nearby village of Somersham and Claydon. We did not visit these sites during this inspection. At the main site there is a dispensary for those patients who are entitled to use it. We did not visit this as part of our inspection.
- The practice has a team of eight GPs, four female and four male, to meet patients’ needs. Seven of the GPs are partners, meaning they hold managerial and financial responsibility for the practice and one is a salaried GP. There is a nursing team of one advanced nurse practitioner, who prescribes, four practice nurses, and another was due to start in September, two health care assistants and three phlebotomists who run a variety of appointments such as long term conditions, minor illness and family health. There is a dispensary manager and a team of dispensers. In addition, there is one practice administrator and a team of non-clinical administrative, secretarial and reception staff who support the practice manager.
- The practice is open between 8.30am and 6.30pm on Monday, to Friday and 8.45am to midday on Saturday. Out of hours services are provided by Suffolk GP Federation via the 111 service. According to information taken from Public Health England, the practice has a higher than average number of patients aged 75+ years, and a lower than average number of patients 15-34 years, compared to the practice average across England. The practice area is one of the least deprived areas within England, according to information taken from Public Health England’s index of multiple deprivation score.
Updated
6 September 2019
This practice is rated as Good overall. At the previous Care Quality Commission (CQC) inspection in February 2016, the practice received requires improvement overall. A further inspection was completed in January 2017, where the practice remained rated as requires improvement.
Our announced comprehensive inspection on 8 May 2017 was undertaken to ensure that improvements had been made following our inspections carried out in February 2016 and January 2017, the practice received a good rating overall.
We carried out an announced comprehensive inspection at Needham Market County Practice on 26 March 2018 as part of our inspection programme.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Requires Improvement
Are services well-led? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) – Good
At this inspection we found:
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The practice routinely reviewed the effectiveness and appropriateness of the care it provided through clinical audit. It ensured that care and treatment was delivered according to evidence- based guidelines.
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Data from the Quality and Outcomes Framework showed patient outcomes in many areas were above the national averages. To ensure this was managed well, the practice had increased clinical oversight into reviewing, improving, and monitoring their performance.
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All patients had a named GP who took responsibility for their care. The practice prioritised continuity of care and patients were encouraged whenever possible to see their named GP
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Staff told us they were happy to work at the practice and felt supported by the management team. Staff told us they were encouraged to raise concerns and share their views.
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Results from the July 2017 national GP patient survey were generally in line with or above local and national averages.
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Patients and staff told us that telephone access could be difficult and patients often attended the practice in person to book their appointments. On the day of the inspection we observed that there was a large queue of patients at the practice waiting for the practice to open. Patients that we spoke with and comment cards that we received advised us that they attended the practice in person because it is easier than attempting to access the practice by telephone. The practice had recently updated their telephone system and the practice informed us that they had plans to further develop their telephone system.
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Information on the complaints process was available for patients at the practice and on the practice’s website. There was an effective process for responding to and investigating complaints and responses to patients were made in a timely manner. However, learning points identified were not always recorded or shared with the whole team staff.
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The practice held various meetings including clinical and non-clinical. Minutes were taken but these did not always contain sufficient detail to ensure staff who had not been present would receive the information.
- The practice had implemented a suite of practice specific policies and procedures which staff had read and were using. We saw a new practice intranet system was in place and this was in the process of being fully populated safely and systematically.
The areas where the provider should make improvements are:
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Review and improve the systems and processes to ensure that information and learning is shared with the whole practice team including information from complaints and significant events.
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Improve the take up of health checks for patients with a learning disability.
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Review and improve access for patients accessing the practice by telephone.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice