Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at James O’Riordan Medical Centre on 27 October 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected 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.
• Most risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Most staff had received training appropriate to their roles.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 very supported by management. Staff had received appraisals and attended regular staff meetings.

• Policies and procedures were accessible for staff and were updated to reflect changes in practice systems.

• The practice sought feedback from staff and patients, and they were in the process of developing the Patient Participation Group (PPG).

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

Importantly the provider should:

• Review practice systems for monitoring and recording staff training.
• Proactively make effective use of coding to enhance the ability to monitor patient outcomes.
• Ensure that the Patient Participation Group is formally established.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

James O’Riordan Medical Centre is a long-established GP practice situated in Sutton, close to the borough boundary with west Merton. It is housed in purpose-built premises especially designed for general practice, and has a practice list of some 5,900 patients. The practice does not provide GP services at any other sites.

During our inspection we spoke with GPs, the Practice Manager, the Practice Nurses (one substantive and one locum), and reception and administrative staff. We also spoke with patients and their families.

Patients and their families had confidence in the treatment and care they received and they praised reception staff for being helpful, caring and polite. It was easy for patients to get through to the practice to make an appointment to see a GP, and the practice worked well with other services to ensure patients’ treatment and care was well-coordinated.

The practice had faced some challenges recently with two partners reducing the number of sessions they worked at the practice, the addition of a new partner, and the introduction of the NHS electronic medical information system for patient records. The practice had also had to contend with periods of extended unforeseen leave of absence due to ill health amongst its clinical staff. This impacted on the ability of some patients to see the GP of their choice and had also disrupted some of the practice’s plans, for example to establish the virtual Patient Participation Group to help improve its services. The day-to-day operation of the practice was well managed and patients received services that were safe, effective, caring and responsive, although we found some areas for improvement.

The practice was looking to broaden the scope and range of services it provided and to establish more robust systems for monitoring and improving the quality of its services. The practice had identified one of the GP partners to lead on the development of the practice’s plans for the future and succession planning.

Older people benefited from one of the GPs having a background in geriatric medicine and sharing their expertise with colleagues. GPs visited people at home where this was required.

The practice held disease management clinics for people with some long term conditions, for example diabetes, to keep them as well as possible. It carried out regular blood monitoring checks for patients reliant on certain drugs that have potentially serious side-effects.

A system was in place for GPs to assess how urgently children and babies needed to be seen. It was the practice’s policy to see all babies and children on the same day an appointment was requested for them.

The practice operated extended opening hours to make it easier for working age people to get an appointment to see their GP, and provided a range of services aimed at preventing disease, for example NHS Health Checks.

People in vulnerable circumstances, for example teenage parents-to-be, had access to specialist primary care services. The practice was responsive to people’s needs based on religious grounds.

People experiencing poor mental health were referred to appropriate psychological and psychiatric services. The practice completed physical health checks and offered health promotion advice to patients with a serious mental illness.

While situated in Sutton, the practice had elected to be a member of NHS Merton Clinical Commissioning Group (CCG).

The practice is registered with the Care Quality Commission (CQC) to carry on the following regulated activities:

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

The practice has not been inspected by CQC before.