Hanscombe House Surgery

Updated 5 August 2016

Hanscombe House Surgery provides a range of primary medical services, including surgical procedures, from premises at 52A St Andrews Street, Hertford, Hertfordshire, SG14 1JA. The practice has approximately 9,727 patients and provides services under a General Medical Services contract (a nationally agreed contract).

The clinical team consists of five GP partners; three of which are male and two are female. There are four practice nurses and one health care assistant. The non-clinical team consists of a practice manager, assistant practice manager, a reception manager and a team of administration and reception team members.

The practice serves a below average population of those aged from 15 to 34 years. There is a higher than average population of those aged from 35 to 59 years. The population is just over 96% White British (2011 Census data). The area served is less deprived compared to England as a whole.

The practice is open to patients between 8.30am and 6pm Monday to Friday. Appointments with a GP are available from 8.30am to 11.30am and from 2pm to 6pm Monday to Friday. Weekend appointments are offered from 8am to 11.30am on two Saturdays a month. Emergency appointments are available daily with the duty doctor or nurse practitioner. A telephone consultation service is also available for those who need urgent advice. Home visits are available to those patients who are unable to attend the surgery and the practice is also able to offer home visits via the Acute In Hours Visiting Service. This is a team of doctors who work across East and North Hertfordshire to visit patients at home to provide appropriate treatment and help reduce attendance at hospital.

The out of hours service is provided by Hertfordshire Urgent Care via the NHS 111 service.

Updated 5 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Hanscombe House Surgery on 12 July 2016. This was to check that improvements had been made following the breach of legal requirements we identified from our comprehensive inspection carried out on 15 December 2015.

This report only covers our findings in relation to the areas requiring improvement as identified on inspection in December 2015. You can read the report from this comprehensive inspection, by selecting the 'all reports' link for Hanscombe House Surgery on our website at www.cqc.org.uk. The areas identified as requiring improvement during our inspection in December 2015 are as follows:

• Risk assess a member of the non-clinical practice team and determine whether or not a Disclosure and Barring check is required.
• Develop an effective system to assess and manage risks to patients receiving high risk medicines.

Our key findings on this focused inspection were that the practice had made improvements since our previous inspection and was now meeting regulations that had previously been breached. Specifically:

• A robust system was in place for the effective management of patients receiving higher risk medicines.
• The practice had risk assessed the role of a member of the non-clinical practice team and a Disclosure and Barring Service check had been completed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 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. Performance for diabetes related indicators was comparable with the local Clinical Commissioning Group (CCG) and national averages. The practice nurse held an annual meeting with the local specialist in diabetes to review the practice caseload. Longer appointments and home visits were available when needed. The practice had an appointment recall system in place and worked closely with the local out of hours service. All patients with a long-term condition had a named GP and for those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 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’s uptake for the cervical screening programme was 82% which was in line with the national average of 82%. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice offered a range of family planning services and the GPs also provided ante-natal and post-natal care. The midwife from the local NHS trust held regular clinics at the practice. The practice worked closely with the local hospital to promote weekly baby clinics held for patients at the local hospital for child development checks and immunisations.

Updated 10 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, this included enhanced services for dementia and end of life care. Weekly visits to a local nursing home were carried out by GPs and treatment provided for minor ailments. The practice also provided emergency visits to the home. The practice was responsive to the needs of older people, and offered home visits and urgent appointments as and when needed. The practice had completed 364 health checks for patients aged over 75 since October 2014, which was nearly 50% for this population group. Flu vaccination rates for patients aged over 65 were higher than the national average.

Updated 10 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. It provided a health check to all new patients and carried out routine NHS health checks for patients aged 40-74 years. The practice was proactive in offering online services such as appointment booking and repeat prescriptions services, as well as a full range of health promotion and screening that reflects the needs for this age group. It offered an appointment reminder text messaging service and appointment times were offered on two Saturdays each month between 8am and 11.30am.

Updated 10 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 96% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. Performance for mental health related indicators was better than the local and national average. The practice had a lead GP for patients experiencing poor mental health and offered regular reviews and same day contact. Patients were referred to a counselling service which offered up to six sessions per patient. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It 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 understood how to support people with mental health needs and dementia.

Updated 10 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. It offered longer appointments and annual health checks for people with a learning disability. The practice held a register of carers, two staff members were nominated as carer champions and were proactive in offering health checks, flu vaccinations and information and advice about local support groups and services. Interpreter services were available to patients whose first language was not English and a deaf interpreter service was also available. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff had received safeguarding training and 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.