Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cowley Road Medical Practice on 11 April, 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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.

• Improvements were made to the quality of care as a result of complaints and concerns.

• Patients said they found it easy to make an appointment with a named GP and 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.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

The practice had a proactive policy of registering patients who may have had difficulty registering elsewhere, including failed asylum seekers, those with addictions and patients who demonstrate challenging behaviour. It also considered on a case-by-case basis keeping patients registered after they had moved out of area, if they would benefit from continuity of care. The practice was currently presenting a case to the CCG for additional funding for the care of asylum seekers and refugees, and was involved in a project to use medical students as mentors for those who had newly arrived in the city. It had also recently welcomed a university anthropology student to spend time in the practice researching the use of interpreters in GP practices and was inviting them back to a team meeting for feedback.

The practice provided specific examples of responsive care for patients in vulnerable population groups which demonstrated positive liaison with other agencies to ensure all information was available for decision making, and advocacy regarding issues such as female genital mutilation.

The areas where the provider should make improvement are:

• Maintain the governance of newly implemented procedures, for example regarding prescription form security in consulting rooms.

• The practice needs to find reconsidered ways of improving patients’ attendance for health reviews, particularly those from diverse cultural backgrounds and with English as a second language.For example, by ensuring that patients who are not attending appointments to manage long term conditions are given wider opportunities to engage with local health care provision.
• Risk assess medical equipment including dressings to ensure they are appropriately stored.
• Undertake work to identify more patients as carers, and review its carers’ list regularly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

East Oxford Health Centre is located in Cowley Road, Oxford, Oxfordshire, OX4 1XD

The surgery which is also known as Dr Stevens & Partners is a GP practice in Oxford. It provides primary medical services to approximately 7,600 NHS patients. The practice is situated in a purpose-built building which opened in 2007. The practice is accessible by for patients with mobility issues.

As part of the inspection we talked with six patients, including a member of the patient participation group (PPG). We also received 12 comment cards from patients expressing their written views about the practice. 

During our visit we spoke with a range of staff, including the practice manager, GPs, registered nurses and health care assistants, receptionists and other administrative staff.

The practice is open from 8.30 am to 6 pm on Monday to Friday. During these hours the practice provides telephone triage consultations, a duty doctor system and bookable appointments. Patients could book appointments either in person, over the phone or on-line.

The majority of patients we spoke with during our inspection told us that they were happy with the treatment that they received. Patients described staff as caring and told us they were always treated respectfully by staff. We found that the practice had listened to patient comments and taken action to improve their service.

We saw the practice had a clean and hygienic environment and there were systems in place to safeguard patients from abuse. Clinical decisions followed best practice.

We found the practice was meeting the wide ranging needs of its patients and the varying levels of demand that were placed on it.

Patients received a caring service. We saw patients being treated with sensitivity by reception staff, and patients we spoke with confirmed the reception staff were polite and respectful.

Governance and risk management measures were in place but we found that some governance arrangements needed strengthening to ensure the systems identified and addressed minor issues we found in recruitment, the storage of medicines and the identification of training needs.

The practice was well-led and responsive to the needs of patients attending the practice. Staff were positive about the management and leadership team and felt supported in their roles. They said their suggestions to improve the service were always listened to. All staff attended staff meetings and contributed positively to developing the practices service.

We found that the practice had met the regulations and provided services that were safe and effective.

During our inspection we looked at how well services are provided for specific groups of people and what good care looks like for them. The population groups we reviewed were:

• Older people

• People with long-term conditions

• Mothers, babies, children and young people

• The working-age population and those recently retired

• People in vulnerable circumstances who may have poor access to primary care

• People experiencing mental health problems

We found the practice provided a responsive service for patients within each population group. Patients were able to access appointments and there were systems in place to ensure patients received an individualised and caring service. The surgery had carefully considered the needs of vulnerable patients and worked in partnership with other organisations to ensure that these patients were supported with their health and social care needs.

We reviewed the information available to us about Cowley Road Medical Practice on 29 May 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.