Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Broadway Medical Practice on 21 April 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, caring, well-led, effective and responsive services. It was also good for providing services for the following population groups: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); People whose circumstances may make them vulnerable; People experiencing poor mental health (including people with dementia).

At the previous inspection in September 2014 we issued a compliance action for a breach of Regulation 12 (Requirements relating to workers) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. As part of this inspection we checked to see if the provider had taken action to address this. We found the improvements required had been made.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned. The continuing development of staff skills, competence and knowledge was recognised as being integral to ensuring high-quality care. Staff were pro-actively supported to acquire new skills.
• 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 were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice, including:

• Staff from the practice had played leading roles in the development and introduction of the Extended Access Scheme in operation within the West locality in Sunderland since November 2014. One of the GPs and the practice manager were part of the steering group, which had led and helped to implement record sharing agreements and mobilised shared access across 15 practices in the locality.
• All of the practice staff had completed dementia friends training in December 2014. They told us this had helped them to understand how they could help people living with this condition more effectively.
• Staff were consistent in supporting people to live healthier lives through a targeted and pro-active approach to health promotion and prevention of ill health, and every contact with patients was used to do so. For example, a GP we spoke with told us it had been identified that acute kidney injury admissions were rising. In response they had enacted the practice to produce leaflets to explain to patients how to minimise the risk of acute kidney injuries. The practice now issued this leaflet to all patients attending appointments for the management of chronic diseases and when patients started taking high risk medicines.
• The involvement of other organisations was integral to how services were planned and delivered and ensured that services met patients’ needs. There were many examples of engagement, including with the CCG and other practices on the extended access scheme, with the CCG for the medicines optimisation local incentive scheme and with secondary care providers.
• Patients’ individual needs and preferences were central to the planning and delivery of services. Longer appointments were available for patients on request and were routinely offered to patients who required them. For example, to older patients, those with chronic co-morbidity and also to patients who had difficulty accessing the surgery due to complicated domestic circumstances.

However there was one area of practice where the provider needs to make improvements.

Importantly the provider should:

• Review and improve the systems used to centrally record, monitor and review significant events and safety alerts within the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The practice is located in Springwell Health Centre, Sunderland and provides primary medical care services to patients living in Springwell and surrounding areas of the City of Sunderland. The practice does not have any branch surgeries, so the inspection was focused on this location.

We held a listening event where members of the public could tell us about their experiences of GP services within Sunderland. We also asked patients prior to our visit to complete CQC comment cards about their experiences of the service they had received. We spoke with representatives from the Patient Participation Group (PPG) and patients attending for appointments during the inspection. We spoke with staff working in the practice on the day of the inspection.

Processes are in place to identify unsafe practices, and measures are put in place to prevent avoidable harm to people. The practice learned from incidents and took action to prevent a recurrence.

Care and treatment is being delivered in line with current published best practice. Patients’ needs are being met and referrals to other services are made in a timely manner. The practice is regularly undertaking clinical audit.

All of the patients we spoke with said they are treated with respect and dignity by the practice staff at all times. Patients also reported they feel involved in decisions surrounding their care or treatment.

Patients said they are satisfied with the appointment systems operated by the practice. The practice has a policy for handling any concerns or complaints people raise.

There is an established management structure within the practice. Staff demonstrated an understanding of their areas of responsibility and report feeling supported and valued by their peers.

The practice is in breach of the regulation that covers requirements relating to workers.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

We reviewed the information available to us about Broadway Medical Practice on 14 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.