Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sunderland GP Alliance - The Galleries

17 October 2017. Overall the practice is rated as requires improvement.

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.

• Data from the Quality and Outcomes Framework (QOF) for 2016/17 showed that patient outcomes were below average at 91.7% when compared to local and national averages.

• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.

• The practice was aware of and complied with the requirements of the duty of candour.

The areas where the practice must make improvements are;

• Ensure care and treatment is provided in a safe way to patients (See Requirement Notice Section at the end of this report for further detail).

The areas where the provider should make improvements are:

• Continue to improve the system for management of chronic disease and medication reviews.

• Continue to improve the patient experience in relation to making appointments, in line with the practice action plan.

• Obtain records of staff immunisations, where necessary, for existing staff.

• Monitor the frequency of the cleaning of curtains in treatments rooms.

• Develop and review the carers register.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating October 2017 – Requires Improvement)

The key questions at this inspection are rated as:

Are services safe? – Outstanding

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Sunderland GP Alliance- The Galleries on 22 November 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear and comprehensive 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. There were clear processes for the escalation and investigation of risk. The practice proactively involved staff through quarterly safety newsletters.
• There was a strong focus on safeguarding with clear and comprehensive processes, and active engagement with other relevant organisations.
• 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.
• The practice had designed, developed and improved processes and technology to improve its ability to manage demand for appointments in order to meet its patient’s needs.
• Some of the practice’s National GP Patient Survey results from January to March 2018 were significantly below local and national averages for questions relating to access to care and treatment. However the practice had invested heavily in new communication systems, analysis and workforce planning to improve access. More recent patient feedback was largely positive with many patients commenting that access had improved. Complaint numbers relating to access had reduced considerably.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.

We saw an area of outstanding practice:

• The provider actively promoted staff involvement and communications across its three sites by initiatives including regular safety, safeguarding and complaints newsletters. This reflected a genuinely open and transparent safety culture where concerns raised were valued as integral to learning and improvement.

Whilst we found no breaches of regulations, the provider should:

• Continue to develop QOF reporting including correcting historical coding and exception reporting issues.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.