This practice was previously inspected in August 2017 and rated as Requires improvement overall.

This practice is now rated as Good overall.

The key questions are rated as:

Are services safe? – Good

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 The Smethwick Medical Centre on 2 May 2018 to follow up on breaches of regulations that were identified in the August 2017 inspection.

At this inspection we found:

• The practice had taken appropriate action following our previous inspection in August 2017 to ensure they were acting on patient feedback to improve patient experience. They had employed additional clinical staff, increased the number of face to face appointments and provided appropriate training for staff to improve communication skills.
• Patients we spoke with and comments cards we received showed there had been an improvement in staff communication, leading to improved patient satisfaction.
• Patient feedback relating to the appointment system and telephone access remained mixed, however, we saw the practice had taken action since our last inspection to try and improve patient experience and they were monitoring patient feedback.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. However, we saw not all records were completed in line with the provider’s policies.
• When incidents did happen, the practice learned from them and improved their processes.
• 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.
• The practice employed an elderly care nurse who was able to provide holistic support to patients and their carers.
• The practice was actively involved in research. The practice gave us examples of how this research benefited their patients including diagnosis of medical conditions previously undiagnosed.

The areas where the provider should make improvements are:

• The provider should continue to ensure patient feedback is monitored and demonstrate they are responding appropriately.
• The provider should ensure all safety records are completed in line with their own policies.
• The provider should consider monitoring patients referred to social prescribing schemes in order to evaluate effectiveness.
• The provider should continue to monitor and take appropriate action to improve uptake for cervical screening.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out an announced comprehensive inspection at The Smethwick Medical Centre on 22/08/2017. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the latest national GP patient survey (published July 2017) were lower than CCG and national averages in relation to patient satisfaction on consultations. While there had been some improvements in the results for nurse consultations and helpfulness of reception staff since the previous national patient survey those relating to GP consultations had declined.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. However, feedback from the latest national GP patients survey showed areas where access to appointments was below CCG and national averages with some patients finding it difficult to access the service by phone and obtain appointments.
• The practice told us of actions being taken to improve patients satisfaction with the service but had yet to demonstrate the impact of those.
• 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 supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvements:

• The provider must ensure effective systems for responding to patient feedback such as that received through the national patient survey so as to identify areas for further improvement and take action as appropriate in order to improve the patient experience.

Dr Janet Williamson

Deputy Chief Inspector of Primary Medical Services and Dentistry