Nuffield House Doctors Surgery

Updated 6 December 2021

Nuffield House Doctors Surgery is located in Harlow, Essex in premises shared with health visitors, and speech and language therapists at.

Minchen Road

Harlow

Essex

CM20 3AX

There are parking bays for patients who are disabled or with limited mobility to the side of the building. There is a public car park available to others close by.

The list size of the practice is approximately 12,600. There are five GP partners and a salaried GP. They are supported by three practice nurses and a healthcare assistant. There are a team of administrative and clerical staff led by a practice manager.

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

The practice is situated within the NHS West Essex Clinical Commissioning Group (CCG) area and delivers through a General Medical Services (GMS) contract.

The practice is part of a wider network of local six GP practices.

Information published by Public Health England shows the deprivation within the practice population is in decile 5 which is in the middle of the deprivation score.

According to the latest available data, the ethnic make-up of the practice area is 89% White, 5% Asian, 1.3% Mixed, 3.6% Black, and 0.4% Other.

The age distribution of the practice population closely mirrors local averages.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance. Many GP appointments are telephone consultations however, the practice doors remained open during the pandemic so if the GP needed to see a patient face-to-face this was offered.

Extended access is provided by a local practice hub, and patients are directed to NHS 111 for healthcare outside practice opening hours .

Updated 6 December 2021

We carried out an announced inspection at Nuffield Doctors Surgery on 15 November 2021. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 12 October 2020, the practice was rated requires improvement overall. Specifically, they were rated requires improvement for safe, caring and long-term conditions. We rated the key questions of effective, responsive, and well-led as good. We issued a requirement notice at this inspection. However, we took them out of special measures in recognition of the significant improvements they had made to the quality of care provided by this service.

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

Why we carried out this inspection

This was a comprehensive inspection to follow up on the breaches of the regulations identified at the last inspection, other areas where the practice was told should be improved, and to re-rate the practice.

How we carried out the inspection

Throughout the pandemic the CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system and discussing the findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short 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 have rated this practice as good overall.

We found that:

• The breaches found in the previous inspection had been complied with and actioned. The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Diabetic patients were identified, and their treatment and monitoring was well managed.
• Patients prescribed high risk medicines had been reviewed regularly and monitoring was well documented.
• Prescribing guidelines were being followed and processes to monitor prescribing had been improved throughout the practice.
• Patients received effective care and treatment that met their needs. The patient records we reviewed remotely showed care pathways and protocols were well managed and followed.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care. This was explained to us when we spoke with patients when we visited the practice.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment throughout the pandemic in a timely way.
• The way the practice managed, promoted, and delivered high-quality, person-centre care. This was seen in the numerous improvements undertaken since the previous inspection.

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

• Continue to improve the effectiveness of their two weeks wait process.
• Continue to improve the areas of negative variations of patient satisfaction in the GP patient survey.

We found an area of outstanding practice:

• The provider had pro-actively sought out care and treatment opportunities to improve the quality of services delivered to their patients throughout the Covid-19 restrictions. Other than for a period of one week, the practice remained open to patients so that they could attend the surgery in person, to receive care and treatment and to book appointments. They also introduced extra communication measures to keep in touch with care homes, domiciliary, and social care to provide a person-centred continuous service. This initiative resulted in the practice being awarded a ‘Hidden Heroes’ award for outstanding performance during the Covid-19 pandemic.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care