Letter from the Chief Inspector of General Practice

We carried out a focussed inspection at Little London Surgery on 8 September 2016.

The practice had previously been inspected in November 2015 and was rated as requires improvement for providing safe services and good for responsive. At this time we identitied a breach of regulation around safe care and treatment. This was because the provider did not keep records to reflect the appropriate management of the cold chain (the safe storage and handling of vaccinations). Additionally, records were not in place to support that risk was effectively managed in the absence of disclosure and barring service (DBS) checks for staff and for specific risks associated with health, safety and infection control. During the previous inspection the practice had not reviewed the 2015 national GP patient servey in order to consider whether improvements were needed to improve patients’ experience of the service.

Following the inspection the practice sent us an action plan detailing the actions they were going to take to improve.

We carried out a focused inspection to check whether the provider had made improvements in line with our recommendations and to ensure regulations are now met. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Little London Surgery on our website at www.cqc.org.uk.

We found that during our inspection on 8 September 2016, the practice had improved systems and we found the following key findings:

• The practice had established systems and processes to keep patients safe.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. There were effective systems in place to alert the practice when training updates were required.

• Risks associated with health, safety and infection control were effectively assessed and well managed. There were adequate arrangements in place to respond to emergencies and major incidents.

• The practice had systems in place to effectively monitor and audit their processes, including patient correspondence and risk management systems

• The practice had proactively sought patient feedback via patient surveys, and findings had been acted on. The national GP patient survey published 7 July 2016 showed slight improvements in some areas of patient access however were still below local and national averages.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The visit to the practice was announced 48 hours in advance of the inspection. This was to ensure we had the opportunity to speak to the GPs and staff working at the practice. We visited the practice to establish that the needs of patients using the service were being met. During the inspection process we spoke with 22 patients, three staff members, two GPs and the practice manager.

Generally the patients we spoke with were complimentary about the service provided by the administration and reception staff. Patient’s voiced concerns about the appointment system. We saw from minutes of meetings that work was underway to identify ways of improving the system. A new telephone and triage system was being introduced in March 2014.

Most of the patients told us that they received care, treatment and support that met their needs, particularly when they saw their preferred GPs. We found that most patients had a preference to which GP they saw. One patient said: “The doctors listen to me. They asked about my history asked how I was getting on. They gave me advice regarding exercise and an exercise sheet”.

Patients were invited to comment on the quality of the service through the national patients’ satisfaction survey, the complaints procedure and a suggestion box. There was a patient participation groups (PPGs) working with the practice to continue to improve the service provided to patients.

We reviewed the information available to us about Little London Surgery on 14 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.