Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bath Row Medical Practice on 25 August 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.

• 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.

• Most patients said they found it easy to make an appointment with a named 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.

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

• Improve the identification of patients who are carers so that they may be given appropriate support.

• Improve the identification of patients who have a learning disability so that they may be given appropriate support.

• Identify ways to improve the uptake of patients for national breast and bowel cancer screening.

• Continue to monitor the appointment system to ensure improvements in patient satisfaction are made.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with six patients and with six members of staff.

Patients we spoke with told us that staff were respectful and courteous towards them. When patients received care or treatment they were asked for their consent and their wishes were listened to. One patient told us: "Yes, it's not a problem."

We saw that patients' views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. The patients we spoke with provided positive feedback about their care. A patient told us: "I'm 99.9% satisfied." Patients received their medicines when they needed them.

Staff had received training in safeguarding children and vulnerable adults. They were aware of the appropriate agencies to refer safeguarding concerns to ensure patients were protected from harm.

The premises had been purpose built, well maintained, safe and clean. They were accessible for patient's with restricted mobility.

The provider had a system in place for monitoring the quality of service provision. There was a system to regularly obtain opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff.

Patient's records were kept securely and had restricted staff access. Policies and procedures concerning staff practices and the day to day running of the practice were available to relevant staff.

At the time of our inspection the provider (senior doctor) told us that one of the partners had left the practice who was also one of the registered managers. The Care Quality Commission had not been informed of this.

This practice is rated as Good overall; we carried out an announced comprehensive inspection at Bath Row medical practice as part of our regular inspection programme on the 15 May 2018.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? –Require Improvement

Are services well-led? - Good

At this inspection we found:

• The practice had sustained a change to clinical staffing levels which had impacted on appointment availability. In response to patient feedback the provider had implemented telephone appointments, extended hours and emergency doctors to deal with on the day requests, but the practice were still unable to manage demand.
• The practice had further developed their policy with regards to identifying carers, this had led to a small increase in numbers of carers identified.
• The practice had an active patient participation group (PPG) who had formed a patient panel and advised the practice on patient engagement.
• We found that the practice’s performance in the Quality and Outcomes Framework (QOF) was in line with the local and national averages. Exception reporting was high in comparison to local and national averages.
• We found the practice to be organised and have comprehensive policies and procedures to guide staff. Staff we spoke with described the practice as supportive and a good place to work.

The areas where the provider should make improvements are:

• Continue to review current processes to improve patient access.
• Consider ways to improve and encourage patients to attend cancer screening.
• Proactively identify carers within the practice population to ensure they receive the appropriate support.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice