Fownhope Medical Centre

Updated 24 February 2020

Fownhope Medical Centre is in Fownhope, Herefordshire.

The practice is registered with the CQC to carry out the following regulated activities - Diagnostic and screening procedures, Surgical procedures, Family planning, Maternity and midwifery services and Treatment of disease, disorder or injury.

When the practice is closed, out of hours cover for emergencies is provided by Taurus Healthcare and is available for patients seven days per week at three hubs in Herefordshire. Patients can book appointments from their own GP practice during opening hours or through a dedicated telephone line when their GP practice is closed. At the time of our inspection there were 5,790 patients on the practice list.

The practice has five GP partners, two GP trainees, one physician’s associate, two practice nurses, one health care assistant, a practice manager, a deputy practice manager, dispensers and an administrative team.

Fownhope Medical Centre is in one of the less deprived areas of the county of Herefordshire. The practice catchment area is classed as being within one of the least deprived areas in England. The practice scored 16.79 on the deprivation measurement scale compared with 19.74 locally and 21.80 nationally; the deprivation scale goes from one to 10, with one being the most deprived. People living in more deprived areas tend to have greater need for health services.

National General Practice Profile describes the practice ethnicity as being 98.8% white British, 0.3% Asian, 0.1% black, and 0.7% mixed and 0.1% other non-white ethnicities. The practice demographics show a slightly higher than average percentage of people in the 65+ year age group (27%) compared with the national average of 17%. Average life expectancy is 81.5 years for men and 83.6 years for women compared to the national average of 79 and 83 years respectively. The general practice profile shows that 57% of patients registered at the practice have a long-standing health condition, compared to 54% locally and 51% nationally.

Updated 24 February 2020

We carried out an announced comprehensive inspection at Fownhope Medical Centre on 9 January 2020 as part of our inspection programme. The practice was rated good at the last inspection in October 2014.

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 outstanding overall.

We rated the practice as outstanding for providing caring services because:

• Feedback from patients was consistently positive and was higher than local and national averages.
• There was a strong person-centred culture.
• The practice responded to patient surveys, acted on comments and made improvements where possible. They improved the system to provide more continuity and availability of appointments.
• The patient medicine delivery service provided additional care and support particularly for elderly and housebound patients. There were many occasions when the delivery person had shared concerns about patients with the GPs resulting in visits and on occasions treatment.
• The practice had been awarded Herefordshire GP Surgery of the year in November 2019, which was nominated by patients.

We rated the practice as outstanding for providing responsive services because:

• The practice had designed, developed and improved processes for ensuring it could deliver both urgent and routine GP appointments to meet its patients’ needs. The system identified patient demand for appointments after a long-term audit of appointment availability and patient demand. The results were used to ensure enough urgent appointments and regular appointments were provided each day which also provided continuity of care. The impact was a significant reduction in the volume and unpredictability of unscheduled work. This led to less pressure and stress for patients and staff.
• The patient medicine delivery service provided additional care and support particularly for elderly and housebound patients.
• Patient survey results were consistently higher than local and national averages in relation to timely access to the service.
• Timely access and improvements to appointment availability benefitted all population groups and so we rated all population groups as outstanding.

We rated the practice as outstanding for providing well-led services because:

• The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care.
• There was a strong focus on efficiency, safety and quality service provision for all their patients.
• The practice were very receptive to any changes or improvements staff had suggested. This was demonstrated through the results of a recent staff survey.
• Many initiatives to make improvements within the practice were taken up including review of the protocols for the management of suspected sepsis and prevalence checks to ensure they were identifying all patients at risk of developing diseases.
• A programme of improvement had been initiated by the practice in conjunction with the GP federation and CCG to standardise clinical coding and safeguarding processes.

We also rated the practice as good for providing safe and effective services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.

We saw several areas of outstanding practice including:

• The practice had designed, developed and improved processes for ensuring it could deliver both urgent and routine GP appointments to meet its patients’ needs. The system identified patient demand for appointments after a long-term audit of appointment availability and patient demand. The results were used to ensure enough urgent appointments and regular appointments were provided each day which also provided continuity of care. The impact was a significant reduction in the volume and unpredictability of unscheduled work, resulting in a 15% increase in the total number of routine appointments available each month. This led to less pressure and stress for patients and staff.
• The patient medicine delivery service provided additional care and support particularly for elderly and housebound patients. There were many occasions when the delivery person had shared concerns about patients with the GPs resulting in visits and on occasions treatment.

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

Updated 24 February 2020

Updated 24 February 2020

Updated 24 February 2020

Updated 24 February 2020

Updated 24 February 2020

Updated 24 February 2020