Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Porters Avenue Doctors Surgery on 5 October 2016. The overall rating for the practice was good, the practice was rated requires improvement for providing caring services. The full comprehensive report on the 5 October 2016 inspection can be found by selecting the ‘all reports’ link for Porters Avenue Doctors Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 28 March 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 5 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is still rated as Good.

Our key findings were as follows:

• Results from the 2017 national GP patient survey did not show an improvement, however the practice had carried out their own more recent survey with the same questions as the national survey which did show an improvement.
• Patients surveyed were satisfied with the surgery`s opening hours.
• The practice had increased the number of carers identified from 1% to 2% of its practice population.
• The practice has improved its communications with patients who may have caring responsibilities by displaying posters detailing the support that is available to them.
• The surgery has partnered with the local carers team, who attended the practice twice a month to provide face to face guidance and support to patients with caring responsibilities.
• The practice also sent letters to the patients who had caring responsibilities to inform them about the local carer’s organisation.
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes had improved and were in line with national average. (QOF is a system intended to improve the quality of general practice and reward good practice).
• The practice had also reduced its exception reporting in some areas including patients with diabetes, atrial fibrillation, coronary heart disease, stroke and transient ischaemic attack, depression, heart failure and rheumatoid arthritis. (Exception reporting is the removal of patients from QOF calculations where, for example, the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate).

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However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Continue to ensure that it addresses issues highlighted in the national GP survey in order to improve on the low levels of patient satisfaction.

At our previous inspection on 5 October 2016, we rated the practice as requires improvement for providing caring services as the practice had identified less than 1% of patients as carer’s, patient satisfaction scores were lower than local and national averages. At this inspection we found that the number of carers identified was 2% of the practices list, however the patient satisfaction survey scores were still lower than local and national averages. Consequently, the practice is still rated as requires improvement for providing caring services.

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 Porters Avenue Doctors Surgery on 5 October 2016. Overall the practice is rated as good.

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

• The practice performance in the national GP Patient Survey was below local and national averages for most responses received from patients.
• 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 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.

The areas where the provider must make improvement are:

• Ensure that it addresses issues highlighted in the national GP survey in order to improve on the low levels of patient satisfaction.

In addition the provider should:

• Review its QOF (Quality and Outcomes Framework) achievement and exceptions to identify ways to improve patient treatment.

• Review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice