Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr N A Nayyar and Partners at Riverside Medical Centre on 17 May 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.
• Patients had a variety of appointment options which included sit and wait sessions, pre-bookable and urgent appointments and telephone consultation and advice.

• The practice provided 30 minute appointments for new mums and babies for the six week post-natal check. This additional time allowed the practice to offer improved levels of support and better meet identified needs.

• 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.

We saw one area of outstanding practice:

• The practice had a dedicated learning disability nurse who worked closely with learning disability patients, carers and other health and social care professionals to provide effective and accessible services. The practice had been involved in the development of templates for health checks in association with the local learning disability team, and had provided training and awareness raising amongst other practices of learning disability health care. Of 88 patients on the practice register of patients with a learning disability 94% had a health action plan in place which is reviewed annually. In addition we were provided with examples of how staff had gone out of their way to help patients with a learning disability resolve personal and social problems.

An area where the provider should make improvement was:

• The practice should review its records in relation to the immunity and vaccination status of its staff to ensure that these were up to date.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Riverside Medical Centre is registered with CQC to provide primary care services, which includes access to GPs, minor surgery, family planning, ante and post natal care. It provides GP services for 10,753 patients living in the Castleford area. The practice has five GP partners, a salaried GP, a senior nurse manager, a nurse practitioner, a triage nurse, four practice nurses and three healthcare assistants. It is a teaching practice and had a trainee GP in post at the time of the inspection.

The practice is open Monday to Friday from 8am to 6pm. Patients can book appointments in person, via the phone and online. The practice provides a triage service so patients can discuss their condition with a nurse who, depending on the patient’s symptoms, either advises on treatment or arranges an appointment with one of the practice’s clinicians. The GPs also provide telephone consultations each afternoon. The practice treats patients of all ages and provides a range of medical services.

The practice is registered with the Care Quality Commission to deliver the regulated activities:

• Diagnostic and screening procedures
• Family planning
• Maternity and midwifery services
• Surgical procedures
• Treatment of disease, disorder or injury

The practice had a very good track record for maintaining patient safety. They worked collaboratively with five other practices in the area to look at how they could continually improve the service and learn lessons from any incidents that had occurred in the patch.

The patients we spoke with and who completed the CQC comment cards were extremely complimentary about the care and treatment being provided.

Staff were responsive to patients’ needs. They had set up and maintained a very active patient participation group (PPG) and readily listened to their views and suggestions.

The building was well-maintained and very clean. Effective systems were in place for the oversight of medication. Clinical decisions followed best practice recommendations.

We found that the leadership team was very visible. There were good governance and risk management measures in place.

The practice safely and effectively provided services for all patient groups. The staff were caring and ensured all treatments being provided followed best practice guidance.

We found that the practice had met the regulations and provided services that were safe and effective.