Drs.Allen & Gee Also known as Harston Surgery

Updated 11 August 2016

Harston Surgery is situated in Harston, Cambridgeshire. The practice provides services for approximately 6500 patients. They currently hold a General Medical Services contract having recently transitioned from a Personal Medical Services contract. The practice has two male GP partners and two female salaried GPs. The practice regularly has medical students training there. The team also includes two female practice nurses and two phlebotomists, one male and one female. They also employ a practice manager and a team of dispensary/ reception/administration/secretarial staff. The practice dispenses to 95% of the patients registered with them.

The practice’s opening times are from 8.30am until 6pm Monday to Friday. The practice has opted out of providing GP services to patients outside of normal working hours such as nights and weekends. During these times GP services are provided by Urgent Care Cambridgeshire via the 111 service.

We reviewed the most recent data available to us from Public Health England which showed that the practice had a higher than average practice population aged over 45 and a lower than average practice population aged between 15-44 compared to national England average. The deprivation score for the area was less than the average across England.

Updated 11 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 18 February 2016. We set a requirement in relation to Safe Care and Treatment. The practice sent in an action plan informing us about what they would do to meet legal requirements in relation to the following;

• The practice must make arrangements to monitor out of date controlled drugs in line with regulations until they are disposed of.
• Put in place a robust process for monitoring the security of medicines at the remote collection points.

They told us these issues would be addressed by 31 April 2016 and provided us with evidence to show they had taken the action to address the concerns.

We undertook a desk top review on 18 July 2016 to make a judgement about whether their actions had addressed the requirements.

The overall rating for the practice is good. You can read our previous report by selecting the ‘all reports' link for on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 March 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. The practice used the information collected for the Quality and Outcomes Framework (QOF) and performance against national screening programmes to monitor outcomes for patients. QOF is a system intended to improve the quality of general practice and reward good practice. Data from 2014/2015 showed; Performance for asthma related indicators was 100%, which was better than the CCG average by 2.4% and the England average by 2.6%. Performance for dementia related indicators was 96.2% which was above the CCG average by 1.2% and the England average by 1.7%. Performance for diabetes related indicators was 92.6%, which was below the CCG average by 6.9% and the England average by 6.6%.

• Longer appointments and home visits were available to patients when needed.

• The practice offered health checks for patients who needed long term condition management.

• 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 held flu vaccination clinics in the community for patients who could not attend the practice.

Updated 31 March 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 A&E attendances. Safeguarding meetings were held every month and safeguarding was a standing agenda for the weekly GPs meetings.

• Immunisation rates were comparable to the CCG average for the standard childhood immunisations.

• 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 80.2%, which was below the CCG and England average by 1.6%.

• The practice had notices up in the waiting room about chlamydia screening and all their patients aged 15 to 24 years were encouraged to have chlamydia testing as appropriate. Forms and testing kits were available.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice had a private room available for breast feeding.

Updated 31 March 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 people in its population.

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

• The reception staff were aware of patients without transport and booked appointments to suit their needs.

• The practice offered health checks for patients aged over 75.

• They offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care.

• The practice offered a delivery service for medications dispensed from the practice for housebound patients, and medicines were packed into compliance aids for those who found it difficult to manage their medicines. The practice had arranged for several shops to act as collection points.

Updated 31 March 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. They offered telephone consultations during the day to patients that might not be able to access the surgery during normal hours.

• The practice offered online booking services as well as a full range of health promotion and screening that reflected the needs for this age group.

• The practice offered the NHS health check programme for patients between the ages of 40-74.

• The practice offered a Travel clinic which included being a yellow fever centre, sexual health support, diet and weight management and smoking cessation which were offered by the nursing staff.

• The waiting room had an area where the patient could do their own health checks which included a machine which took their blood pressure and scales to measure their weight.

Updated 31 March 2016

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

• The practice carried out advance care planning for patients with dementia. 89.7% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was above the CCG average by 5.4% and the England average by 5.7%.

• All patients with mental health concerns were offered annual health checks.

• 91.3% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in their record in the preceding 12 months which was above the CCG average by 4.3% and the England average by 3%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• 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 might have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 31 March 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 people, travellers and those with a learning disability. They operated a system to invite patients with learning disabilities in for an annual health check. The practice had completed annual health checks for all 13 patients registered with learning disabilities this year, and had actively encouraged their patients to attend with letters. If the practice received no response they contacted patients by telephone.

• The practice regularly visited patients in the local learning disabilities home and liaised with the home manager.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.