Horsefair Surgery - Care Quality Commission

Background to this inspection

Updated 7 March 2017

West Bar Surgery is a GP practice located slightly to the west of Banbury town centre on the second floor of a modern building in Banbury in north Oxfordshire. There is a branch surgery; known as Hardwick Surgery was is located approximately two miles away in the Ferriston area of Banbury. West Bar Surgery is one of the practices within Oxfordshire Clinical Commissioning Group (CCG) and provides general medical services to approximately 17,000 registered patients. A CCG is a group of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

Services are provided from:

West Bar Surgery, South Bar House, 6 Oxford Road, Banbury, Oxfordshire OX16 9AD

Hardwick Surgery, Ferriston, Banbury, Oxfordshire OX16 1XE

During the February 2017 inspection, we only visited West Bar Surgery.

According to data from the Office for National Statistics, Oxfordshire has minimal economic deprivation. However, the practice provides GP services within the second highest area of deprivation within Oxfordshire, with the highest number of patients outside of Oxford on opioid substitution therapy (a therapy which supplies illicit drug users with a replacement drug) and the highest number of children subject to Child Protection Plans in Banbury.

The age distribution of the registered patients is largely similar to the national averages. Although there is a slightly lower than average number of patients aged between 20 and 29 years of age.

The practice provides GP services to two local independent schools (approximately 413 patients). The practice population also has a proportion of patients in 12 local care homes (approximately 130 registered patients).

Ethnicity based on demographics collected in the 2011 census shows the population of Banbury and the surrounding area is predominantly White British with 5.7% of the population composed of people with an Asian background and 1.4% of the population composed of people with a Black background.

Over the previous two years the practice has seen a significant amount of change, including changes of key members of staff including GP Partners, the practice manager and departmental managers.

The practice comprises of six GP Partners (three female and three male), three salaried GPs (one female and two male) and a GP Registrar (male). West Bar Surgery is a training practice for GP Registrars. GP Registrars are qualified doctors who undertake additional training to gain experience and higher qualifications in general practice and family medicine. In addition, there was also a full time pharmacist employed by the practice.

The all-female nursing team consists of two nurse practitioners, four practice nurses, five health care assistants one of which is also a phlebotomist.

The practice manager is supported by several departmental managers and a team of reception, administrative and secretarial staff who undertake the day to day management and running of West Bar Surgery.

West Bar Surgery is engaged with the apprentice programme and also has two apprentices who undertake administration and reception duties.

West Bar Surgery is open between 8am and 8pm every Monday and Thursday (appointments between 8am and 7.45pm) and between 8am and 7.30pm Tuesday, Wednesday and Friday with appointments available from 8am to 7.15pm. The branch surgery (Hardwick Surgery) is open every Monday, Wednesday and Friday. On Monday the branch surgery was open between 2pm and 6.30pm with appointments available between 2pm and 6.15pm. On Wednesday and Friday the branch surgery was open between 8.30am and 12.30pm with appointments available between 8.30am and 12.30pm.

The practice has opted out of providing the out-of-hours service. This service is provided by the out-of-hours service accessed via the NHS 111 service. Advice on how to access the out-of-hours service is clearly displayed on the practice website, on both practices door and over the telephone when the surgery is closed.

Overall inspection

Good

Updated 7 March 2017

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at West Bar Surgery in Banbury, Oxfordshire on 27 July 2016 found breaches of regulations relating to the provision of caring and responsive services. The overall rating for the practice was requires improvement. Specifically, we found the practice to require improvement for the provision of caring and responsive services. The practice was rated good for providing safe, effective and well-led services. The concerns which led to these ratings applied to everyone using the practice and we rated all population groups as requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for West Bar Surgery on our website at www.cqc.org.uk.

This inspection was an announced follow up inspection carried out on 24 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations (Regulation 17: Good Governance) that we identified in our previous inspection on 27 July 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the practice had made improvements since our last inspection. At our inspection on the 24 February 2017 we found the practice was meeting the regulations that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the practice is now rated as good. All six population groups have also been re-rated following these improvements and are also rated as good.

Specifically the practice had:

Effectively assessed, monitored and improved the quality of the services provided. Patient feedback from various sources showed significant improvement in terms of the quality of care received and access to care.

Implemented an action plan with 26 specific, measurable and timely actions with a view to improve patient satisfaction. Actions included a review of ‘demand and capacity’ resulting in additional employment and deployment of staff members.

Completed an in-house patient satisfaction survey, which saw significant improvement in terms of patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice