Background to this inspection
Updated
13 December 2017
Dr Jackson and Partners (also known as Mayford House Surgery), Boroughbridge Road, Northallerton, North Yorkshire, DL7 8AW is situated in Northallerton serving patients in Northallerton and the outlying smaller villages.
The registered list size is 9773 and predominantly of white British background. The practice scored eight on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have greater need for health services. The practice age profile is comparable to the England average, the largest percentage above the England average being 65 years plus. The practice is a dispensing practice and dispenses to approximately a 3,400 patients of the patients.
There has been a change in the partnership arrangement and clinical staffing since the last inspection. The practice is managed by four partners (three female and one male) and two salaried GPs (one male and one female). The practice employs an advanced nurse practitioner (ANP), a practice nurse manager, two practice nurses and two health care assistants. They also employ a pharmacist, a dispensary manager and two dispensers. The team is supported by a new full time practice manager and assistant practice manager and a range of secretaries, IT staff and a reception team.
The practice is a training practice for qualified doctors who are progressing to their chosen speciality both in primary and secondary care. The practice occasionally has medical students attached to the practice. The practice is part of the ‘Heartbeat Alliance’ a federation of other practices in the Hambleton, Richmondshire and Whitby Clinical Commissioning Group (CCG).
The practice is open between 8.30am and 6.30pm Monday to Friday. Extended hours are offered one evening a week from 6.30pm to 8pm. In addition to this, as part of the local Federation ‘Better Access’ pilot, extended opening hours appointments are also offered every Monday and Wednesday and every other Friday from 6.30pm to 8pm. General appointment times for GPs are from 8.40am to 11.30am, 2pm until 4pm and either 3pm to 5pm or 4pm to 6pm. There is a sit and wait clinic at 11.30am daily for urgent and non-urgent appointments. Standard appointments are 10 minutes for face to face and five minutes for telephone calls. A phlebotomy service is available daily.
The practice has opted out of providing out-of-hours services to its own patients. When the practice is closed, patients are directed to Harrogate District Foundation Trust (the contracted out-of-hours provider) via the NHS 111 service. The practice holds a General Medical Services (GMS) contract to provide GP services which is commissioned by NHS England.
Updated
13 December 2017
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Jackson and Partners on 10 May 2016. The overall rating for the practice was requires improvement. We undertook a further announced focused inspection on 24 January 2017. The overall rating for the practice remained at requires improvement. The full comprehensive reports on the May 2016 and January 2017 inspections can be found by selecting the ‘all reports’ link for Dr Jackson and Partners on our website at www.cqc.org.uk.
This inspection was an announced comprehensive carried out on 16 November 2017 to check whether the provider was now meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This practice is rated as Good overall. (Previous inspections May 2016 and January 2017 – Requires improvement)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider should make improvements are:
Consideration should be given to whether specific complaints need to be recorded as significant events.
Review the systems in place for reviewing changes introduced overtime for significant events and complaints to assess whether the changes have been effective and embedded into practice.
Consider the arrangements in place to support non--clinical staff to be aware of patients at risk of sepsis.
Review the process for regular monitoring of prescriptions that have not been collected.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice