Background to this inspection
Updated
30 March 2020
Westrop Medical Practice, Newburgh Place, Highworth, Swindon, Wiltshire, SN6 7DN is located within the Swindon local authority and is one of 21 practices serving the NHS Swindon Clinical Commissioning Group (CCG) area.
Westrop Medical Practice (also known as Highworth Surgery) is in a single storey purpose built medical centre in an area of Swindon known as Highworth. There are three branch surgeries known as Blunsdon Surgery, Hermitage Surgery and Taw Hill Surgery all of which are located within proximity of each other.
Westrop Medical Practice provides general medical services to approximately 27,500 patients and dispensing services from Blunsdon Surgery. Due to its patient population size, it has become a Primary Care Network (PCN) in its own right. PCNs are a key part of the NHS Long Term Plan, with general practices being a part of a network, typically covering 30,000-50,000 patients. These networks then provide the structure and funding for services to be developed locally, in response to the needs of the patients they serve.
The practice has a lower proportion of registered patients (56.9%) who are of working age when compared to the CCG and national averages of 62.5% and 62% respectively. It has a higher percentage (25.3%) of elderly patients over 65 years of age when compared to the local and national averages, which are 15.5% and 17.3% respectively.
We visited Highworth Surgery, Blunsdon surgery and Taw Hill Surgery as part of this inspection and found accessible facilities, with ground floor consulting and treatment rooms at both sites. We did not visit The Hermitage Surgery as part of this inspection.
Information published by Public Health England rates the level of deprivation within the practice population group as ninth on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
The practice partners are contracted to provide General Medical Services (GMS) and are registered with the CQC for the following regulated activities: diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
The clinical team comprises a mix of 12 GP partners and salaried GPs (three of whom are GP trainers), two advanced nurse practitioners, one paramedic practitioner, two mental health nurses, ten practice nurses, five health care assistants, two clinical pharmacists, three physiotherapists, one health and social wellbeing adviser and three dispensing staff and ten additional administration and reception staff.
For non-clinical activities, a Business and Finance Manager oversees the management of Westrop Medical Centre, assisted by an Operations Manager based at each of the three other locations, all of whom are then supported by thirty-six additional admin and reception staff, spread across the four locations.
Out of hour’s services are not provided as these are provided by Medvivo whose contact details are available in the practice and on the website.
The provider is registered to provide regulated activities from the following locations:
- Westrop Medical Centre, Newburgh Place, Highworth, Swindon, Wiltshire, SN6 7DN
- Blunsdon Surgery, 36 Berton Close, Blunsdon, Swindon, Wiltshire, SN26 7BE
- Hermitage Surgery, Dammas Lane, Swindon, Wiltshire, SN1 3EF and
- Taw Hill Surgery, Aiken Road, Swindon, Wiltshire, SN25 1UH
Updated
30 March 2020
We carried out an announced comprehensive inspection at Westrop Medical Practice on 30 January 2020 as part of our inspection programme.
We carried out an inspection of this service following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change (either deterioration or improvement) to the quality of care provided since the last inspection in August 2016 due to a significant expansion of the practice by its merger with two other local practices. In addition, we also followed up on concerns and breaches of regulation identified at the Taw Hill Medical Practice inspection under the old provider of this location. This was to ensure improvements had been made and patients were receiving safe care and treatment.
When we last inspected Westrop Medical Practice in August 2016 it had been rated as good overall; good for providing safe, effective, caring, responsive and well led services and good for all the population groups.
At the time of that inspection Westrop Medical Practice consisted of a main practice, in the market town of Highworth, and a small branch surgery located in the village of Blunsdon. Since then, two other local surgeries have merged with Westrop Medical Practice; The Hermitage Surgery in 2017 and, more recently, Taw Hill Surgery in October 2019. We visited Highworth Surgery, Blunsdon surgery and Taw Hill Surgery as part of this inspection.
This inspection focused on the following key questions:
- Are services safe?
- Are services effective?
- Are services caring?
- Are services responsive?
- Are services well led?
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 Westrop Medical Practice as good overall; good for providing safe, effective, caring, responsive and well led services and good for all the population groups because:
- At this inspection, we found all of the concern areas from the last Taw Hill site inspection had been improved. We saw evidence that by being integrated within Westrop Medical Practice and adopting their policies, procedures and methods of working, these areas had been addressed and improvements made.
- Patients’ needs were assessed, and care and treatment was delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
- The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
- Staff had the skills, knowledge and experience to deliver effective care, support and treatment.
- Staff worked together and with other organisations to deliver effective care and treatment.
- There was compassionate, inclusive and effective leadership at all levels. This included working with and supporting the practice Patient Participation group (PPG).
- The practice had a clear vision and set of values that prioritised quality and sustainability.
- The practice had a culture that drove high quality sustainable care.
- There were clear responsibilities, roles and systems of accountability to support good governance and management.
- There were clear and effective processes for managing risks, issues and performance.
Although we did not find any beaches of regulation on this inspection, we did see areas where the provider should make improvements. These are:
- Continue to monitor exception reporting rates to ensure they are applied accurately and in line with guidance.
- Review processes to provide consistent and appropriate authorisations to administer medicines when Patient Group Directions are updated.
- Continue to review arrangements to improve the uptake of cervical screening.
We did, however, find examples of outstanding practice particularly about the work put in by all practice members in the integration and merging of Taw Hill surgery into Westrop Medical Practice. This included:
- The responsiveness shown by the practice in responding to patient and staff dissatisfaction at Taw Hill.
- Improved governance and leadership
- Improved engagement with patients, staff and external partners.
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