Archived: Ledbury Market Surgery

Updated 12 December 2019

Ledbury Market Surgery provides primary medical services for patients in Ledbury and is in the centre of the town with easy access to nearby parking.

The provider, Taurus Healthcare Ltd, took on the APMS contract in August 2018 in a caretaker capacity to maintain the service provision. They were also contracted to prepare the service for transformation in Ledbury with the merger with St Katharine’s surgery by April 2020. The provider will maintain a partnership function with the merged service to provide resilience and support.

Ledbury Market Surgery is part of the Herefordshire Clinical Commissioning Group (CCG) and provides services to 5,034 patients under the terms of an Alternative Provider Medical Services (APMS) contract. The APMS contract allows NHS England to contract with ‘any person’ under local commissioning arrangements.

At the time of the inspection the practice was only registered with the CQC to provide one of the regulated activities of surgical procedures. Steps had been taken to address this and the provider had submitted applications to add the following regulated activities of diagnostic and screening procedures; family planning; maternity and midwifery services; and treatment of disease, disorder or injury to its registration with CQC. The applications were being processed.

The clinical team consists of five GPs, three of whom are full time and two part time. The team includes two practice nurses (one of whom is a prescriber) and two health care assistants (HCAs). The clinical team is supported by the practice manager and a team of reception and administration staff.

There are higher than average numbers of patients between the ages of 49-79, and fewer patients from 20-29 years of age than the national average. The National General Practice Profile states that 1.9% of the practice population is from non-white ethnic groups. Information published by Public Health England, rates the level of deprivation within the practice population group as eight, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 81 years compared to the national average of 79 years. Female life expectancy is 86 years compared to the national average of 82 years.

Updated 12 December 2019

We carried out an announced comprehensive inspection at Ledbury Market Surgery on 8 October 2019 as part of our inspection programme.

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 and good for all population groups.

We found that:

• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• There were clearly defined systems, processes and practices in place to keep people safe and safeguarded from abuse and for identifying and mitigating risks of health and safety.
• For patients with the most complex needs GPs worked with other health and care professionals to deliver a coordinated package of care.
• Urgent same day patient appointments were available when needed. All patients who completed comment cards before our inspection said they were able to obtain same day appointments and access care when needed.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• Patients with long-term conditions had a structured annual review to check their health and medicines needs were being met.
• Results from the national GP patient survey revealed a high level of patient satisfaction about the care given at the practice which was either in-line with or above local and national averages. For example, 95% of patients who responded said that the last time they had a general practice appointment, the healthcare professional was good or very good at treating them with care and concern and 100% had confidence and trust in the healthcare professional they saw or spoke to.
• There were comprehensive policies and procedures to support best practice.
• There were clear responsibilities, roles and systems of accountability to support effective governance.

The areas where the provider should make improvements are:

• Continue to identify carers, developing and improving the support available to them as set out in the service action plan.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care