Derwent Practice

Updated 18 July 2023

Derwent Practice is located in Malton, Yorkshire and provides services from, Norton Road, Norton, Malton, YO17 9RF we visited this location as part of our inspection.

The practice is registered with the Commission as a partnership of GPs. The provider is registered to deliver the regulated activities of diagnostic and screening procedures; maternity and midwifery services; treatment of disease, disorder or injury; and surgical procedures.

The practice is situated within the Humber and North Yorkshire Integrated Care Board (ICB) and delivers a General Medical Services contract (GMS) to a patient population of about 21,000. This is part of a contract held with NHS England.

Information published by Public Health England shows that deprivation within the practice population group is in the seventh most deprived decile (7 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 98.2% White 0.8% Asian, 0.7% Mixed, and 0.37% Black.

There are 10 GP partners and 5 salaried GPs working at the practice, 9 are male and 6 are female. They provide 92 sessions per week. The practice has a nurse manager, nurse practitioner, 4 practice nurses, 3 health care assistants and 4 phlebotomists working at the practice. There is a team of reception/administration staff.

The practice is a training practice who have GP trainees allocated to the practice (fully qualified doctors allocated to the practice as part of a 3-year postgraduate general practice vocationaltraining programme). They also host medical students who are third or fifth-year medical students who are not yet qualified to practice.

The practice provides extended access appointments at the surgery on Saturdays and Sundays. This is part of the enhanced services contract ran in conjunction with other GP practices in the area. Appointments are available at other local practices on evenings on Tuesdays and Thursdays. This service was offered via pre-bookable appointments. Out of hours services are provided by via the NHS 111 service.

Updated 18 July 2023

We carried out an announced focused inspection at Derwent Practice on 25 and 31 May 2023. Overall, the practice is rated as Good.

Safe – Requires improvement.

Effective - Good.

Caring - not inspected, rating of good carried forward from previous inspection.

Responsive - Good.

Well-led – Good.

At our previous inspection of 10 April 2019, the practice was rated good overall and for all of the key questions of safe, effective, caring, responsive and well-led.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Derwent Practice on our website at www.cqc.org.uk

Why we carried out this inspection.

We carried out this inspection to follow up concerns reported to us.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

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.

We found that:

• From the results of our clinical searches, we saw that patients did not always receive the correct monitoring for high-risk medicines or regular reviews of their long-term conditions. There was no protocol in place for this.
• Patient safety alerts had not been responded to, although a recent process had been set up.
• In the main, systems were in place to keep patients safe, which took into account current best practice.
• 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.
• There was a proactive approach to anticipating and managing risks. Innovation was encouraged to achieve sustained improvements.
• The leadership at the practice were working together to improve the delivery of high-quality, community focused, person-centred care.
• There were high levels of staff satisfaction. Staff were proud of the organisation and there were high levels of staff engagement. Leaders endeavoured to motivate staff.
• There was a proactive approach to seeking new ways to provide care and treatment.

Whilst we found no breaches of regulations, the provider should:

• Improve and embed effective monitoring and review processes for all patients who are prescribed medicines to treat long term conditions.
• Improve and embed effective processes to manage and act upon patient safety alerts.
• Continue to take steps to train staff on their awareness and on the procedures for significant events.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services.