Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at City Health Care Partnership CIC - The Wolds Primary Care Practice on 15 July 2016. The practice, which provides a service to registered patients as well as a nurse led walk in service, 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.
• The practice had arrangements in place to identify patients that were attending the minor injuries unit (MIU) with ‘red-flag’ ailments. Red-flag ailments are those that could be deteriorating health situations for example chest pains, shortness of breath and children’s health problems. New walk-in patients indicated their current health status to the receptionists on their registration at reception.
• 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.
• 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 were able to get same day appointments and pre bookable appointments were available.
• Urgent care was available on the same day for registered patients with the GPs and for un-registered patients via the walk in service. Arrangements were in place to ensure continuity of care by referring patients back to their registered GP once their care in the minor injuries unit had been completed.
• 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 needs to make improvements.

Importantly the provider should:

• Implement a system to identify the patients with the most urgent needs through early assessment by a clinician.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This service is rated as Good overall. (Previous

inspection July 2016 – Good. In July 2016 all the population groups were rated good. The population groups were not inspected at this inspection as we only looked at the urgent treatment centre aspect of the service. The previous rating of good still apply).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an unannounced focused inspection at The Wolds Primary Care Practice on 12 and 13 July 2018 in response to concerns that CQC became aware of in relation the to the Urgent Treatment Centre (UTC) aspect of the service.

At this inspection we found:

• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service investigated them and identified lessons and areas for improvement.

• The provider was developing a process for clinically assessing patients within required timescales when they attended the UTC, to enable them to meet the national NHS England Urgent Treatment Centres – Principles and Standards by March 2019.

• Staff had the knowledge, skills and competence to deliver care to patients.

• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated people with compassion, kindness, dignity and respect.

• Patients could access care and treatment for their needs from the service between the NHS England

recommended opening times.

• There was a leadership structure but staff did not feel they could always access support from the

management team.

The areas where the provider should make improvements are:

• Continue to develop the process so patients are clinically assessed in line with NHS England: Urgent

Treatment Centres – Principles and Standards’ by March 2019.

• Implement a system to monitor that access to GP advice is available to nurses/emergency practitioners when required.

• Improve communication and access between staff and the management team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice