Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The New Medical Centre on 12 January 2017. The overall rating for the practice was requires improvement. We rated the practice overall requires improvement due to lack of governance issues particularly in relation to low Quality Outcomes Framework (QOF) scores and low National GP Patient Survey scores. The full comprehensive report on the January 2017 inspection can be found by selecting the ‘all reports’ link for The New Medical Centre on our website at www.cqc.org.uk.

This inspection was undertaken following the January 2017 inspection was an announced comprehensive inspection on 4 October 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Not all of the patients we received feedback from said they found it easy to make an appointment with the practice.
• Results from the National GP Patient Survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns and this learning was shared with all members of staff.
• Patients and carers of patients with life-limiting conditions had been identified by the practice and were holders of the practice ‘Goldcard’.The ‘Goldcard’ allowed easy access to clinical services at the practice.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Patients rated their overall experience at the practice lower than the Clinical Commissioning Group (CCG) and national averages.
• There was a leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• Continuous improvement was encouraged by the partners. We saw examples of support to staff to undertake studies to gain further knowledge as well as the practice taking part in a local pilot which would help identify a potential new way of processing patient data.

The areas of practice where the provider should make improvements are:-

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care, in particular with regards to addressing continuing patient concerns highlighted in the National GP Patient Survey scores.
• Continue to review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is available to them.

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 The New Medical Centre on 12 January 2017. Overall the practice is rated as Requires Improvement.

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

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Not all of the patients we received feedback from said they found it easy to make an appointment with the practice.
• Results from the National GP Patient Survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns; however this learning was not shared with all members of staff.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Patients rated their overall experience at the practice lower than the Clinical Commissioning Group (CCG) and national averages.
• 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 provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were below the CCG and the national averages.

The area where the provider must make improvements are:

• Ensure effective and sustainable governance systems and processes are implemented to monitor the practice performance and the quality of services provided, in particular in relation to establishing an action plan to address the low Quality and Outcomes Framework (QOF) scores achieved by the practice.

In addition the provider should:

• Ensure that all members of staff conduct information governance training.
• Devise an action plan to address patient concerns as highlighted by low scores contained within the National GP Patient Survey.
• Ensure joined up working between the partners and the practice management in order that all aspects of practice governance and performance are viewed as a whole.
• Devise a system to regularly monitor unplanned admissions of patients on the practice list.
• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is available to them.
• Ensuring that prescription forms are securely stored at all times.
• Share learning gained from significant events and complaints with all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced focused inspection at The New Medical Centre on 3 April 2019.

At this inspection we followed up on breaches of regulations identified at a previous inspection on 4 October 2017. Where the practice was found Good overall and for the domains, safe, effective, caring, well led and for all of the population groups. With the exception of responsive where it was found to require improvement.

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,
• information from the provider, patients, the public and other organisations.

We have rated this practice as good for providing a good service for all of the population groups in responsive and responsive overall. This is because: -

• The practice has complied with the breaches of regulation found during the inspection of 4 October 2017.
• The practice has taken steps to review the GP patient survey and respond to its findings. It has made changes to the service to ensure that patients access to service improved.
• The practice now monitored and responded to NHS Choices comments.

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.