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