Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cofton Medical Centre on 3 August 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. The practice carried out an annual significant event audit to ensure learning from significant events was embedded.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. The GPs were leads in different areas and had weekly meetings to discuss concerns and share learning. The administrative staff also had lead roles in different areas.

• There was a clear leadership structure and staff felt supported by the GPs and the practice manager. The practice proactively sought feedback from staff and patients which it acted on. There was a very pro-active Patient Participation Group (PPG) of which we met with two members during the inspection and spoke with another member by telephone.

• The practice was aware of and complied with the requirements of the duty of candour.

• Risks to patients were assessed and well managed.

• Patients described staff as caring and helpful. Patients commented that they were treated with dignity and respect

• 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 named GP and there was continuity of care, with urgent appointments available the same day.

• One of the GPs at the practice provided a locality substance abuse service. They reviewed practice patients but also patients from a number of local practices. The service involved prescribing methadone, monitoring well-being and providing health checks. In the last two years the GP had reviewed 25 patients from different practices and 70 patients who are registered with the practice.

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

Importantly the provider should:

• Consider ways to improve patient experience in areas highlighted in the national patient survey.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as RI overall.

The key questions at this inspection are rated as:

Are services safe? – RI

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - RI

We carried out an announced comprehensive inspection at Cofton medical Centre on 1 October 2018 as part of our inspection programme.

At this inspection we found:

• Following the inspection, the practice was able to demonstrate that in most cases patients on high risk medicines were monitored appropriately.
• There was an inconsistent approach to managing emergency medicines and medicine safety alerts.
• General clinical oversight and management was not always consistent. however, individual leaders demonstrated that they were competent in their own roles.
• Systems used by the practice to ensure patients were safeguarded from abuse were comprehensive and effective.
• The practice uptake rates for breast, bowel and cervical cancer screening were in line with local and national averages.
• Childhood immunisation uptake at the practice was above the national target rate of 90%.
• The practice proactively engaged with local improvement schemes from the local commissioning group.
• The practice performance in the national GP patient survey was consistently above local and national averages. Patient feedback we received was positive about the practice.
• The practice had analysed and responded to the needs of a changing population.
• The practice demonstrated that they had developed an open, friendly and honest culture that we saw benefitted both staff and patients.

The areas where the provider MUST make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider SHOULD make improvements are:

• Consider ways to ensure that overall trends of complaints and incidents are highlighted to ensure that potential risks are identified and mitigated.

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

Please refer to the detailed report and the evidence tables for further information.