Letter from the Chief Inspector of General Practice

The practice is rated good overall and is now rated good for providing effective and well services.

We carried out an announced comprehensive inspection of this practice on 11 February 2016. Breaches of legal requirements were found during that inspection within the effective and well led domains. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. As a result, we undertook a focused follow up inspection on 26 September 2016 to follow up on whether action had been completed to deal with the breaches.

During our previous inspection on 11 February 2016 we found the following areas where the practice must improve:-

• Ensure that all staff, including administrative staff have received training in relation to safeguarding both adults and children.

• Ensure there is a robust plan in place to develop the practice patient participation group

Our previous report also highlighted areas where the practice should improve:-

• Ensure they hold safeguarding information in one place in the form of a register.
• Ensure action relating to infection control audits includes timely completion dates and monitoring of action taken.
• Review feedback from patients relating to patient consultations and involvement in their care and take appropriate action to improve satisfaction in these areas.
• Continue to address issues relating to patients satisfaction with opening times and telephone access and monitor changes in relation to this.
• Address patient concerns relating to access to appointments and their preferred GP.
• Review quality and outcomes framework (QOF) exception reporting and take action to ensure this is aligned to local and national reporting rates.
• Take action to improve the uptake of cervical screening and ensure the practice holds records relating to this.
• Take action to improve the seasonal flu vaccine rates for patients over 65 and those in clinical risk groups.

We conducted a follow up focused inspection on 26 September 2016 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During this inspection we found:

• All staff, including administrative staff had received training in relation to safeguarding both adults and children
• Robust plans were in place to develop the practice patient participation group

We also found in relation to the areas where the practice should improve:

• That safeguarding information was now collated on one register that was accessible to all relevant staff
• Actions arising from an audit of infection control had been followed up and completed.
• The practice had improved access to the appointments system by allowing patients to phone up and book appointments the afternoon before. They had also expanded the triage system to ensure that appointments were prioritised according to clinical need.
• Action had been taken to address lower levels of patient satisfaction with continued efforts to recruit additional GPs to vacant posts. The practice had also secured longer term locum GPs to provide more continuity for patients.
• The practice had taken action to improve the uptake of cervical screening by translating the invitation letter in to Polish in order to reach this part of the community. It was also in the process of introducing a text message reminder system.
• In order to reduce the level of exception reporting there was a dedicated member of staff responsible for encouraging patients with learning disabilities and mental health problems to attend for their annual reviews.
• The practice had planned three Saturday morning flu clinics to encourage and improve the uptake of the vaccine by for patients over 65 and those in clinical risk groups

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bognor Medical Centre on 11 February 2016. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

• The practice had appropriate safeguarding processes in place, however not all administrative staff had attended safeguarding training.
• The practice had taken action to develop a patient participation group (PPG) however this was with limited success in relation to the practice actively encouraging and receiving feedback about the quality of care and the overall involvement of patients.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• The practice had a system of alerts for patients with whom there were safeguarding concerns which meant that patients were known to the practice, however they did not have an internal safeguarding register in place.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on however action plans were not always clear for all areas of lower than average satisfaction. For example, in terms of patient feedback relating to patient consultations and feeling involved in their care.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The practice had produced patient information in a variety of relevant language formats to meet the needs of their large number of patients from Eastern Europe.

The areas where the provider must make improvement are:

• Ensure that all staff, including administrative staff have received training in relation to safeguarding both adults and children.

• Ensure there is a robust plan in place to develop the practice patient participation group

The areas where the provider should make improvements are:

• Ensure they hold safeguarding information in one place in the form of a register.

• Ensure action relating to infection control audits includes timely completion dates and monitoring of action taken.

• Review feedback from patients relating to patient consultations and involvement in their care and take appropriate action to improve satisfaction in these areas.

• Continue to address issues relating to patients satisfaction with opening times and telephone access and monitor changes in relation to this.

• Address patient concerns relating to access to appointments and their preferred GP.

• Review QOF exception reporting and take action to ensure this is aligned to local and national reporting rates.

• Take action to improve the uptake of cervical screening and ensure the practice holds records relating to this.

• Take action to improve the seasonal flu vaccination rates for patients over 65 and those in clinical risk groups.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice