The Harvey Practice

Updated 10 November 2016

The Harvey Practice is located at 18 Kirkway, Broadstone, Dorset BH18 8EE. The practice is based in an urban area of Poole and provides services to patients living in the Broadstone, Merley and Corfe Mullen areas of East Dorset. The practice provides services under a NHS General Medical Services contract and is part of NHS Dorset Clinical Commissioning Group (CCG).

The practice has approximately 7000 patients registered and is situated in an area of low deprivation and low unemployment compared to the averages for England. The practice population has a higher proportion of older patients and a lower proportion of working aged patients compared to the averages for England. The practice population has a higher number of patients with a long-standing health condition compared to the national average. A total of 63% of patients registered at the practice have a long-standing health condition compared to the national average of 54%.

The Harvey Practice has a branch surgery three miles away at 81 Merley Lane, Merley, Dorset BH21 3BB. The management of both locations is organised at The Harvey Practice. Patients are able to make appointments at both locations.

The practice employs three male GP partners, three female GP partners, and two salaried GPs one of whom is female and one is male. The GPs work across both The Harvey Practice and the branch surgery. Together, the GPs provide care equivalent to just under five full time GPs over 69 sessions per week. The GPs are supported by one full-time Nurse practitioner, who is a non-medical prescriber. Three practice nurses and two health care assistants also provide a range of services to patients. Together the nurses are equivalent to just over two full time nurses. The clinical team are supported by a management team including secretarial and administrative staff. The practice also supported individuals working in the modern apprenticeship scheme. The practice is a training practice for doctors training to be GPs and a teaching practice for medical students. At the time of our inspection, there were two GP registrars (trainee GPs) who were supported by the practice.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are available between 8.30am and 12pm and again from 2pm to 6.30pm daily. Extended hours appointments are offered every Monday and Tuesday between 6.30pm and 8pm. The practice telephone lines and reception desk are open between 8am and 6.30pm. The Harvey Practice have opted out of providing out-of-hours services to their own patients and refers them to the treatment centres at Poole General Hospital, Longfleet Road, Poole, via the NHS 111 service.

The practice offers a range of additional in-house services to patients including antenatal care, midwifery, travel advice, counselling, physiotherapy, psychology, counselling, dermatology and chiropody. The practice offers online facilities for booking of appointments and for requesting prescriptions.

Updated 10 November 2016

Letter from the Chief Inspector of General Practice

We carried out a focused desktop inspection of The Harvey Practice on 7 October 2016 to assess whether the practice had made improvements to providing safe care and services.

We had previously carried out an announced comprehensive inspection at The Harvey Practice on 1 March 2016, when we rated the practice as good overall. The practice was rated as good for being effective, caring, responsive and well-led and requires improvement for providing safe care. This was because the employment checks necessary for locum staff were not consistently undertaken. Following our last inspection we asked the provider to send a report of the changes they would make to comply with the regulations they were not meeting at that time.

The practice was able to demonstrate that they were meeting the standards for safe care and is now rated as good for providing safe care. The overall rating for the practice remains as good.

This report should be read in conjunction with the full inspection report. A full copy of the report can be found on the CQC website at: www.cqc.org.uk

Our key findings across the areas we reviewed on 7 October 2016 were as follows:

• Recruitment checks on staff had been appropriately conducted, including locum staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 April 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The percentage of patients with diabetes, whose HbA1c (a test of the average blood sugar reading over three months) was in the acceptable range in the preceding 12 months was better than the national average. The practice achieved 84% compared to a national average of 77%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice delivered education sessions on long-term condition management and support to staff working in nursing homes.

Updated 15 April 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency attendances. Immunisation rates were high for all standard childhood immunisations.
• The percentage of patients diagnosed with asthma who had an asthma review in the last 12 months was 74% compared to a national average of 75%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 82 %, which was comparable to the national average of 82%.
• The practice had developed specific information and advice leaflets for women receiving contraceptive implants and devices.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with health visitors and school nurses.

Updated 15 April 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population, including the use of tools to identify those patients most at risk.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice employed a dedicated GP to support patients who were over 75 years of age.

• A GP conducted weekly ward rounds in three large nursing homes that the practice supports.

Updated 15 April 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• The practice offered extended hours and telephone appointments to those who could not attend the practice in usual opening hours.
• The practice had developed a brief intervention clinic for patients who were concerned about their alcohol intake.

Updated 15 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 80% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded in the preceding 12 months was 93% compared to a national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had contributed to the setting up of a community ‘dementia café’.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 15 April 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless patients, travellers and those with a learning disability.
• The practice offered two reviews a year to all patients with a learning disability. These were offered as home visits as appropriate.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.
• The practice offered support with making social care referrals to patients who identified themselves as carers. However, only 1% of the practice population were registered as carers.