Letter from the Chief Inspector of General Practice

We first carried out an announced comprehensive inspection at Cramlington Medical Group on 1 February 2016. Overall, we rated the practice then as requires improvement. There was a breach of legal requirement. In particular, we found that staff had not completed all of the training they needed to effectively and safety carry out their roles and responsibilities.

After the comprehensive inspection, the practice wrote to us to say what they would do to meet the above regulation. We carried out a comprehensive inspection on 18 November 2016 to check whether the provider had taken steps to comply with the above legal requirement. 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 for Cramlington Medical Group on our website at www.cqc.org.uk.

Overall, the practice is rated as good.

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

• The practice had complied with the requirement notice we set following the last inspection. We found that the practice had ensured that all relevant staff had completed training on the Mental Capacity Act 2005 as stated in the action plan the practice produced following the previous inspection.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Lessons were learned when incidents and near misses occurred.
• Risks to patients were assessed and well managed.
• 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 on the practice website and easy to understand.
• Most patients said they found it easy to make a routine appointment with a GP and there was continuity of care, urgent appointments were available on 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 regulation.

The areas where the provider should make improvements are:

• Review the processes for recording and monitoring the training that is required by staff to carry out their role. 
• Continue to take action to improve the practice’s Quality and Outcomes Framework (QOF) performance.

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 Cramlington Medical Group, on 1 February 2016. Overall, the practice is rated as requires improvement.

Following our previous inspection in May 2015, we rated the practice as inadequate. However, the CQC made a decision not to place the practice into Special Measures, as the previous provider was no longer carrying on the Regulated Activities, and a new provider was in the process of applying for the location to be added to their existing registration.

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

• The new provider had made good progress in addressing the concerns and breaches of regulation we identified during our previous inspection, in May 2015.

• There was an open and transparent approach to safety and a good system for reporting and recording significant events

• The new provider had introduced systems, processes and protocols, which were helping to make sure patients’ needs, were assessed and care was planned and delivered, in line with current evidence based guidance.

• The new provider had made good progress in making sure services were tailored to meet the needs of individual patients. All staff were actively engaged in monitoring and improving quality and patient outcomes, and were committed to supporting patients to live healthier lives through a targeted and proactive approach to health promotion.

• Nationally reported Quality and Outcomes Framework data, for 2014/15, showed that the previous provider’s performance, regarding the provision of recommended care and treatment to patients, was variable. The new provider was taking active steps to address the underlying causes of this and improve the practice’s performance.

• The new provider had made good progress improving the practice’s systems and processes and arrangements had been put in place to identify risks to patients and staff. However, although staff had made improvements to the practice’s patient call and recall systems, potentially inaccurate disease registers kept by the previous provider, posed a continuing risk to some groups of patients.

• The new provider's staff team worked closely with other organisations, and healthcare professionals, when planning how to provide services which met patients’ needs.

• Patients’ emotional and social needs were seen as being as important as their physical needs, and it was evident there was a strong, person-centred culture. Patients said they were treated with compassion, dignity and respect and that they were involved in decisions about their treatment.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The new provider had taken active steps to assure the delivery of high-quality, person-centred care. They supported learning and innovation, and promoted an open and fair culture. Good governance arrangements had been put in place.

However, there are areas where the new provider must make improvements. The provider must:

• Ensure staff complete all of the training they need to effectively and safely carry out their roles and responsibilities.

There are areas where the new provider should make improvements. The provider should:

• Make sure blank prescriptions are stored in line with national guidance and keep them secure at all times.

• Continue to take action to improve the practice’s QOF performance.

• Ensure all patients over 75 years of age have a named GP.

• Continue to demonstrate quality improvement and effective care through the completion of two-cycle clinical audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice