We carried out an announced comprehensive inspection at Lynwood Surgery on 12 February 2019 as part of our inspection programme.

At the last inspection in October 2017 we rated the practice as requires improvement overall.

At this inspection we have rated this practice as good overall.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We rated the practice as Good for providing safe, effective, caring, responsive and well-led services because:

• 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.
• Staff dealt with patients with kindness and respect. Feedback from patients we spoke with and CQC comment cards stated staff involved and treated patients with compassion, kindness, dignity and respect. Although, results from the national GP patient survey showed some patients reported low satisfaction with consultations. The practice had reviewed this feedback and acted on it.
• Complaints were listened and responded to and used to improve the quality of care.
• The practice organised and delivered services to meet patients’ needs. Although, results from the national GP patient survey showed some patients reported low satisfaction with appointments. The practice had reviewed this feedback and acted on it.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The provider should:

• Continue to improve cervical screening and childhood immunisation uptake to bring in line with recognised targets.
• Continue to improve patient satisfaction with consultations and appointments access.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lynwood Surgery on 4 August 2016. At that time the practice was registered under a different provider. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The practice was taken over by a new provider. Due to the practice being rated inadequate the special measures was automatically transferred to the new provider. The full comprehensive report can be found by selecting the Dr Haider Al-Hasani ‘all reports’ link for on our website at www.cqc.org.uk.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 10 October 2017. Overall the practice is now rated as requires improvement.

Our key findings were as follows:

• Improvements had been made since our last inspection. There was an open and transparent approach to safety and a system was in place for reporting and recording significant events. However we have concerns about the lack of consistent clinical leadership at the practice.
• The practice had clearly defined and embedded systems to minimise risks to patient safety, this was an area of improvement since our previous inspection.
• Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Data showed patient outcomes were low compared to the national average in areas such as diabetes care, mental health and cervical smears.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. However there were areas where the practice did not perform well.
• Information about services and how to complain was available.

• Patients we spoke with said they found it easy to make an appointment with urgent appointments available the same day.

• A number of patients commented on how late consultations at the practice often ran. Some patients reported waiting for more than an hour for their appointments.

• The practice had not developed a business plan or strategy.

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

Importantly, the provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition the provider should:

• Sustain the improvements that have been achieved from the GP national patient survey results survey and also make further improvements in areas that are still low.

• Review and improve the process of identifying carers.

• Continue efforts to recruit a fully established patient participation group (PPG) at the practice.

• Improve the waiting times for patients waiting for GP consultations.

I am taking this service out of special measures. This recognizes the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice