We carried out an announced comprehensive inspection at St Luke’s Primary Care Centre on 26 October 2017. The overall rating for the practice was good, however, the practice required improvement in relation to how responsive we found it to be. The full comprehensive report on the October 2017 inspection can be found by selecting the ‘all reports’ link for St Luke’s Primary Care Centre on our website at www.cqc.org.uk.

This inspection was a focused follow up inspection which was completed as a desk-based review, carried out on 3 October 2018, to assess whether the practice had improved in the key area of ‘Responsive’ and made the recommended improvements following concerns that we identified during our previous inspection in October 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice overall rating remains as good.

Our key findings were as follows:

• • The practice had taken action to improve patient satisfaction in relation to access to appointments and had monitored this through surveys and audits.
• • Feedback from patients and data reviewed showed some improvements were being achieved to the appointment system, waiting times and getting through to the practice by telephone.
• • The practice had taken steps to employ more staff to better meet patient needs.
• • Results from the August 2018 national GP patient survey showed that the practice scored below local and national averages in a number of areas. We saw some improvement since the last inspection, however, further improvement was needed in relation to patients’ experience of accessing appointments at the practice. The practice provided evidence that this was an area they were continuing to work on.

The area where the provider should make improvements are:

• • Continue to improve levels of patient satisfaction in relation to access to appointments.

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 St. Luke's Primary Care Centre on 26 October 2017. 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.
• All applicable staff had been checked for their immunisation status in relation to Hepatitis B. At the time of our inspection the practice was in the process of confirming the immunisation status of applicable clinical and non clinical staff in relation to other immunisations.
• 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.
• All staff had received an appraisal within the last 12 months.
• Results from the national GP patient survey published July 2017 showed patients rated the practice lower than others for several aspects of care and access to services.
• The practice was aware of the lower satisfaction recorded in the national GP patient survey and was taking improvement actions. However the impact of these actions were yet to be demonstrated.
• 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.
• The practice had systems to support carers.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a leadership structure and staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The practice was aware of and complied with the requirements of the duty of candour.

The area where the provider should make improvement is:

• Continue to seek feedback from patients using the service and ensure improvement to national GP patient survey results.

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 St Luke’s Medical Centre on 5 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.
• Risks to patients were assessed and well managed. We noted there was no process for recording the actions following safety alerts, however, we did see evidence that these had been actioned. Following our inspection the practice provided evidence that they had implemented a system to address this.

• 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 although patient survey results reported lower than average responses in most areas.
• 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 told us they did not find it easy to make an appointment with any GP and that it was particularly difficult to get an appointment with a GP of choice. There were urgent appointments available the same day, and patients who needed to see a GP urgently could always see one.
• The practice had very 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 and the patient participation group member we spoke with confirmed this.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Continue to address areas of patient dissatisfaction from the national patient survey including customer service training for reception staff.

• Continue to explore ways of improving access to appointments.

• Consider more formal meetings and recording discussions with reception and administration staff.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We spoke with seven patients and seven staff. Patients we spoke with told us doctors listened to them and respected their views and decisions about their own health. Patients told us they had continuity of the same doctors and nurses and received consistency of care. Patients gave us mixed comments about the new appointment system. One patient told us, "I sometimes feel involved in my care but think you have to request things rather than be offered services, for example being referred to a specialist." There were arrangements in place to deal with foreseeable emergencies and ongoing care and staff were well trained.

The provider told us that safeguarding adults and children was a priority at their service. This meant the provider would ensure people who used the service were protected from harm. We found staff were trained and supported to provide care and treatment to people who used services. We saw information about the Patients Participation Group (PPG) in the patient leaflet and in the practice newsletter. This enabled patients to contact the PPG to give feedback and suggestions.