Letter from the Chief Inspector of General Practice

This inspection was an announced focused inspection carried out on 9 August 2017 at the branch location Bosden Moor Surgery, (formerly The Surgery) which is now part of the registration of Heaton Moor Medical Group (HMMG).

HMMG was inspected 15 November 2016 and was rated good overall. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Heaton Moor Medical Group on our website at www.cqc.org.uk.

This GP practice was previously registered to another provider (Dr Yogendra Dutt Sharma) and was known locally as The Surgery. However significant concerns were identified in relation to the key questions safe, effective and well led and the practice was rated inadequate overall and placed into special measures following our first inspection of the practice in February 2016.

At our re-inspection of the GP practice in 7 December 2016 Dr Yogendra Dutt Sharma, the registered provider, was no longer contracted with NHS England to provide primary medical services at The Surgery. The NHS England contract as of the 1 December 2016 was with the GP partners from HMMG.

HMMG had been supporting The Surgery from October 2016 and the re-inspection in December 2016 identified major improvements in the quality and safety of the service provided. HMMG had implemented an effective remedial action plan but recognised further work was required to improve services. The practice was rated as requires improvement overall and one requirement notice was issued. The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for Dr Yogendra Dutt Sharma on our website at www.cqc.org.uk.

HMMG completed the purchase of the GP Surgery in February 2017, notified the Care Quality Commission that the location was now a branch GP surgery and undertook a consultation process with patients to rename the practice to Bosden Moor Surgery. HMMG patients’ register merged with the patients registered at Bosden Moor Surgery in April 2017.

The purpose of this focused inspection was to confirm that HMMG had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection 7 December 2016.

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

• HMMG had successfully implemented a strategy to improve and develop the service provided at Bosden Moor Surgery and had addressed the significant issues, transforming the service provided to one that was safe, effective and well led.
• The practice building had been totally remodelled to a high standard, providing tastefully modern décor and facilities while retaining and enhancing patient access and improving capacity and the variety of the services provided.
• The planned integration of the patient record system with that of HMMG had been completed. This allowed patients to access a range of GP, nurse and specialist appointments across four locations within Stockport.
• Records management was centralised for the majority of administrative tasks, which enabled effective management of patient information.
• The practice had fully implemented and integrated their established governance systems at Bosden Moor Surgery. This ensured all staff had access to standardised policies, procedures and processes regardless of which of the four GP surgeries they were located at.
• Patient medication reviews at Bosden Moor Surgery had been completed and a recall and review cycle established dependent on the individual patient’s needs.
• HMMG were actively trying to engage with patients at Bosden Moor Surgery and invited patients to join the wider HMMG patient participation group.
• HMMG implemented a range of audits including clinical audits.
• Regular multi-disciplinary meetings were held jointly with another of HMMG branch surgery because the same health care professionals covered both localities.
• HMMG was forward thinking and worked collaboratively with the clinical commissioning group (CCG) in piloting new ways of working to improve patient outcomes and to expand the variety of and access to a range of health care and treatment options.
• Staff training plans and annual appraisal were established and implemented.
• We saw that staff treated patients with kindness and respect, and maintained confidentiality.

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 Heaton Moor Medical Group Practice at 32 Heaton Moor Road, Stockport, SK4 4NX and at their branch surgeries located at 95 Dean Lane, Hazel Grove, Stockport, SK7 6EJ and at Offerton Health Centre, Offerton Lane, Offerton SK2 5AR on 15 November 2016. This report covers our findings from all three premises.

Prior to February 2016, there were three separate registered locations and Heaton Moor Medical Group Practice was an amalgamation of these services. Therefore, data we have access to, will not accurately reflect the performance of the current practice and data we usually include has been omitted from the report. The performance of the three practices previously was generally comparable to local and national averages and we had no serious concerns about performance.

Overall the practice is rated as good.

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

• The practices premises were clean and tidy and had disabled access, translation services and a hearing loop.
• There were some systems in place to mitigate safety risks including analysing significant events and safeguarding.
• The practice was aware of and had systems in place to ensure compliance with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).
• Patients’ needs were assessed and care was planned and delivered in line with current legislation.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice sought patient views about improvements that could be made to the service; including having a patient participation group (PPG) and acted, where possible, on feedback.
• The practice was a training and teaching practice and there was a strong focus on learning. Staff worked well together as a team and all felt supported to carry out their roles and supported in career progression.
• The practice had plans to expand further and took an active role in major developments in the transformation planning of healthcare provision across Stockport.

There were outstanding elements of practice including:-

• Each GP had a lead role, for example, safeguarding lead, and this responsibility was rotated on an annual basis so every GP had knowledge of the subject.
• The practice had an open access phlebotomy service every morning and evening.

However, the provider should:-

• Display information about how patients can complain to the service in all premises.
• Monitor the time taken to respond to a complaint and if this exceeds the timeframe set out in the complaints procedure, send an explanation for the reason for the delay to the patient.
• Have a protocol for handling uncollected prescriptions which includes checks to ensure patients have received their medication.
• Display health and safety information posters for staff at the main site and the branch site.
• Ensure emergency medication containers are correctly labelled to avoid inadvertently using the wrong medication.
• Monitor responses/reports from GPs to any requests for sharing information as identified in the safeguarding audit.
• Ensure that records of all relevant recruitment checks for clinicians are kept and monitored.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice