Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Crossfell Health Centre on 4 October 2017. The overall rating for the practice was good. The full comprehensive report on the October 2017 inspection can be found by selecting the ‘all reports’ link for Crossfell Health Centre on our website at .

This inspection was a desk-based review carried out on 6 April 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the ‘should’ that we identified in our previous inspection on 4 October 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At our inspection on 4 October 2017 we reported that: The provider should ensure action is taken to improve telephone access to the Practice. Results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was below local and national averages. We rated the location as requires improvement for providing responsive services.

The practice is now rated as good for providing responsive services.

Our key findings were as follows:

• The provider has made changes to the appointment system which has improved access for patients.
• Did not attend (DNA) rates for the month of March 2018, in comparison to October 2017 had reduced by almost 50%
• The provider has introduced a nine months closure to the patient list to reduce the pressure around access to care.
• Test results and prescriptions can now only be accessed via the telephone after 2pm (for results) and 4pm (for prescriptions) to reduce early morning pressure around telephone access.
• Since October, each GP has additional telephone slots available for consultation
• The provider has now reinstated GP pre-bookable appointments throughout the week. (Previously only offered on Saturdays).
• The patient participation group carried out a survey which asked patients views about telephone access to the practice.

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 Crossfell Health Centre on 4 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• 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.
• 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.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

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

• The provider should ensure action is taken to improve telephone access to the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an inspection of Crossfell Health Centre practice on 22 April 2015 as part of our comprehensive programme of inspection of primary medical services. The inspection team found after analysing all of the evidence that the practice was safe, effective, caring, responsive and well led. It was rated as good for all of the population groups.

Our key findings were as follows:

• The practice was safe. 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 is effective. Patients received care according to professional best practice clinical guidelines. The practice had regular information updates, which informed staff about new guidance to ensure they were up to date with best practice. According to the data from Quality and Outcomes Framework (QOF), an annual reward and incentive programme showing GP practice achievement results, outcomes for patients registered with this practice were average for England.
• The service is caring. Patients reported the positive view they had of the doctors and staff at the surgery. Practice staff knew their patients well. The service ensured patients received accessible, individual care, whilst respecting their needs and wishes. The QOF indicators showed that patients felt listened to and involved in decisions about their care and this was similar to other practices in the area.
• The service is responsive. The appointment system was guided by the needs and views of the patients. Urgent needs were addressed on the day and patients in general were able to see the GP of their choice. The service had positive working relationships between staff and other healthcare professionals involved in the delivery of service.
• The service is well led. The practice had a clear vision and set of values which were understood by staff and made known to patients. There was a clear leadership structure in place. Quality and performance was monitored and risks were identified and managed. We found the practice focused on patient outcomes and the quality of care provided for their patients.

We saw several areas of outstanding practice including:

• To help minimise the disruption to the routine of new mothers and their babies, they were offered combined postnatal and baby appointments, together with baby immunisations.
• The practice provided Musculo-Skeletal service, this helped minimise referrals to secondary (hospital) care. In addition care was provided closer to patients’ homes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice