We decided to undertake an inspection of this service on 8 May 2019 following our annual review of the information available to us. This inspection looked at the following key questions; was the service providing effective and well led services for the registered patient population. We did not decide to inspect whether the practice was providing safe, caring or responsive services as there was no information from the annual regulatory review which indicated this was necessary.

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 and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff were developed and supported to ensure services were of high quality.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• Governance systems were operated including quality improvement initiatives.
• The practice was engaged in local initiatives and worked alongside partners in the local healthcare system effectively.

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

• Consider whether the clinical team have the appropriate training to assess the rights and ability of patients under 16 to consent to care and treatment.
• Review audit recording to ensure that quality improvement is always monitored.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gosford Hill Medical Centre on 17 November 2015. 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.
• 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.
• Patient care was effectively monitored in order to drive improvement.
• 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.
• The practice understood its responsibilities regarding Duty of Candour.
• Patients’ satisfaction in the appointment system similar to other practices in the locality. Some patients reported there was a long wait to see a preferred GP and survey data suggested waiting times in the practice were sometimes an issue. 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.

.We saw one area of outstanding practice:

• The practice cared for patients who had opiate addictions and one GP had specialist skills in this area. This allowed the practice to provide ongoing care for all these patients’ health conditions including those related to their addictions. Out of 33 patients who had opiate addictions five years before the inspection, eight patients had been supported to stop using opiates. Six cases of hepatitis C had been diagnosed among these patients which enabled them to gain treatment.

However there were areas of practice where the provider should make improvements:

• Update nurses’ understanding of the Mental Capacity Act 2005 and rights of children in regards to obtaining consent from under 16s.
• Consider patient feedback regarding waiting times at the practice and consider action to improve.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice