This practice is rated as Good overall. (Previously rated as Good overall in March 2017).

The key questions at this inspection 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 announced comprehensive inspection at Dr Bowry and Bowry’s practice on 13 November 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice 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 patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that the practice was responsive to their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Continue with efforts to improve outcomes for patients with diabetes.
• Continue with efforts to improve the up-take of child immunisations for children aged two and cervical screening.

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.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Drs Bowry and Bowry's Practice on 17 January 2017. We rated the practice as good for providing effective, caring, responsive and well-led services and the overall rating was good. We rated the practice as requires improvement for providing safe services. This was because a number of recommendations made following a fire risk assessment carried out around the time of our inspection remained to be implemented to ensure that safety issues were addressed. We served a requirement notice relating to the practice’s failure to comply with Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

In addition, under the key question of Caring, we found that data from the GP patient survey, published in July 2016, showed that patient satisfaction over appointments with the practice nurse were significantly below average. We had said the practice should take action to improve these results; under the key question of Responsive, we had highlighted that the practice should take steps to inform patients of the availability of translation services; and under the key question of Well-led, we had said the practice should continue with plans to expand the patient participation group (PPG) and increase the frequency of meetings.

The full comprehensive report on the January 2017 inspection can be found by selecting the ‘reports’ link for Drs Bowry and Bowry's Practice on our website at www.cqc.org.uk/location/1-547092313. After the inspection, the practice sent us an action plan confirming that the fire safety recommendation would be implemented for the practice to ensure it was able to meet the legal requirements under the key question, Safe.

This inspection was an announced focussed inspection carried out on 7 September 2017 looking at the issues previously identified and to check and confirm that the practice had carried out its plan to meet the legal requirements. We found that the practice had taken appropriate action to meet the requirements of the regulations relating to providing a safe service, relating to the fire safety issues we had identified. Accordingly, we have revised the practice’s rating in respect of providing a safe service to good.

We also reviewed the GP patient survey results published in July 2017. These showed a substantial improvement of between 10% and 17% in patients’ satisfaction levels over nurse appointments, making them comparable to local and national averages.

We saw that the practice had put up posters in the waiting area regarding the availability of translation services, which was also mentioned on the waiting area television screen.

We also saw evidence that the practice had sought to increase patients’ involvement in the PPG. A meeting had been held in April 2017, attended by five patients and there were plans for more meetings later in the year. The practice had reviewed with the PPG the findings of our inspection in January 2017 and devised an action plan to address any issues and had introduced a patients’ newsletter.

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 on 17 January 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• An annual fire risk assessment had been carried out in October 2016, but actions from it had not been implemented. Another assessment was conducted shortly after our inspection. The practice had acted on a number of its recommendations, but some remained outstanding. 
• Published data showed the practice had been performing below average specifically in relation to diabetes care, although there was evidence of recent improvement.
• 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 found it generally easy to make an appointment and there was good continuity of care, with urgent appointments available the same day.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about how to complain was available and easy to understand.
• 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 improvement is required.

The practice must:

• Implement all the actions highlighted by the recent fire risk assessment

In addition, the practice should:

• Continue with work on improving outcomes for patients with diabetes.
• Continue with efforts to improve patients’ satisfaction with nurses’ appointments.
• Take steps to inform patients of the availability of translation services.
• Continue with plans to expand the patient participation group and increase the frequency of meetings.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice