This practice is rated as Good overall. (Previous rating March 2018 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

We carried out an announced focused inspection at Sunderland GP Alliance – Disruptive Patient Service on 3 April 2019. This was to follow up on breaches of regulations within the safe domain.

At the previous inspection on 20 March 2018 we found that the practice had not always carried out appropriate recruitment and training checks on staff who were used on an occasional ad hoc basis from a different provider within the same building. We also found that safety incidents were not always documented and acted on in a timely fashion.

At this inspection we found:

Breaches of regulations and recommendations made at the last comprehensive inspection had been acted on.

• 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 now had effective systems in place to ensure that when staff were recruited appropriate checks were carried out.
• Appropriate systems were followed for staff training; including for chaperoning.

We saw one area of outstanding practice:

• The provider produced a quarterly safety newsletter across it’s sites which detailed incident types, numbers and learning points, along with a reminder to staff of how to report and where to access learning points. Reductions in quarterly incidents were reported and staff encouraged to make a conscious effort to further improve safety and report incidents. Therefore good practice from the main provider was mirrored in the systems within this offshoot service.

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

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Sunderland GP Alliance – Disruptive Patient Service on 20 March 2018. This was as part of our ongoing inspection programme.

At this inspection we found:

• The practice provided care and treatment for patients who were allocated to them as part of a special allocations scheme. Patients were allocated for a minimum of one year and they were removed from the practice list and returned to a mainstream practice on the successful completion of a risk review process.
• The practice recognised the needs of the patients who were allocated to the practice and provided services to meet their needs. They provided information to patients to make sure they were aware of how to access care and treatment.
• When required the practice supported the patient when they moved to a new practice. For example, by contacting the new practice before and after the patient was registered to ensure the new practice was aware of their background and how any issues had been successfully managed in the past.
• The practice had clear systems to manage risk; however, some of these required improvement so that safety incidents were less likely to happen. When incidents did happen, the practice had not always responded promptly to the issue raised. The practice had not always recognised risks that could affect the practice.
• The practice routinely 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 they were able to access care when they needed it.
• Patients told us the practice was supportive and provided prompt and effective care.

The areas where the provider should make improvements are:

• Look for ways to allow patients to provide feedback to the practice.
• Implement a process to identify and record if patients have caring responsibilities.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients. See the requirement notices at the end of this report for further detail.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice