Park Street Surgery Also known as Dr Ingram & Partners

Updated 15 August 2023

Park Street Surgery is located in Ripon at:

The Surgery

7-8 Park St

Ripon

North Yorkshire

The practice is a dispensing practice. The practice can offer dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. It is also a training practice and has GP trainees and registrars.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning, treatment of disease, disorder or injury and surgical procedures.

The practice is situated within Humber and North Yorkshire Health and Care Partnership. The Partnership is one of 42 Integrated Care Systems (ICSs) which cover England to meet health and care needs across an area, coordinate services and plan in a way that improves population health and reduces inequalities between different groups. The practice delivers General Medical Services (GMS) as part of a contract held with NHS England.

The practice is part of a wider network of GP practices known as Ripon and Masham Primary Care Network which is made up of 4 GP practices. Park Street Surgery is also part of Yorkshire Health Network (YHN). YHN is a Federation of the 17 GP practices in Harrogate and rural district.

The practice scores 9 on the deprivation measurement scale; the deprivation scale goes from 1 to 10, with 1 being the most deprived. People living in more deprived areas tend to have greater need for health services. The current patient list size is just over 7,600.According to the latest available data, the ethnic make-up of the practice area is predominantly white.

Park Street Surgery has 4 GP partners (male and female), 2 salaried GPs (male and female), and 2 GP registrars (A GP registrar is a qualified doctor who is training to become a GP). There is 1 advanced clinical practitioner, 2 practice nurses, 1 senior practice nurse, 1 health care assistant (0.59 WTE), and a practice manager, supported by a team of administration, reception, dispensing and secretarial staff.

The practice is open between 8 am to 6 pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally Mowbray Square in Harrogate and Ripon Hospital, where late evening and some weekend appointments are available. Out of hours services are provided through the NHS 111 system.

Updated 15 August 2023

We carried out an announced comprehensive inspection at Park Street Surgery on 14 and 21 June 2023. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 3 and 9 November 2022, the practice was rated inadequate overall and for the key questions of safe and well led, and placed into special measures.

For providing effective services, the practice was rated as requires improvement. The areas of caring and responsive services were not inspected in 2022, instead the previous ratings of good carried forward from the practices’ first inspection on 20 January 2016.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Park Street Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection, and the previous rating in line with our inspection priorities and special measures guidance.

This inspection included all the key questions of safe, effective, caring, responsive and well led. In addition we assessed compliance with 2 warning notices issued at the previous inspection under regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, these pertaining to safe care, and good governance.

How we carried out the inspection/review

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 and questionnaires.
• Completing 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 patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit.

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 found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm. There had been significant improvements in incident recording, reporting and analysis. Safeguarding procedures and the updating and review of safeguarding registers had improved since the previous inspection.
• Patients received effective care and treatment that met their needs. The provider was able to evidence improvements in patient care and the management of long-term health conditions. There was a comprehensive programme of clinical audit, and evidence of quality improvement initiatives improving patient outcomes.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. There was a strong cohesive staff team, who spoke positively about their leaders. There had been improvements in governance and clinical leadership. Clinical leads took ownership of their respective areas and communicated required changes in a clear and timely manner.
• The practice had made good use of available technology to automate reminders and review dates for staff, which led to more efficient working and improved patient outcomes.

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

• Deliver to completion, in line with given timescales, the programme of improvement works identified in the infection control audit.
• Actively search for and check that urgent cancer referrals have been completed and that the patient attended their appointment.
• Carry out regular retrospective auditing of historical safety alerts to ensure these were actioned correctly at the time.
• Continue to encourage the uptake of cervical screening tests and childhood immunisations.

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.

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