Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tollgate Medical Centre on 4 July 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• Risks to patients were generally assessed and well managed with the exception of those relating to infection control and prescriptions security.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care was consistently positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had strong and visible clinical and managerial leadership and governance arrangements and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.

We saw two areas of outstanding practice:

• The practice showed leadership and took responsibility at an organisational level to improve local child protection arrangements. For example, clinical and non-clinical staff made detailed records of barriers in reporting and communicating individual child protection concerns to allied health and social care professionals. Staff collated and sustained escalation of its concerns until they reached persons responsible for the system. The practices ongoing commitment triggered an analysis of the system to improve child protection arrangements in the local area.
• The practice was responsive to its patients and had proactively engaged its PPG as partners in operational and strategic planning as well as work to engage the local community. For example, the PPG had made suggestions to improve medicines prescribing and the practice facilitated the PPGs direct contact with the local CCG to discuss policy. The PPG made suggestions for improvements to stoma care and diabetes care which led to the practice initiating a borough wide support group and local diabetes educational group within the practice. (A stoma is an opening on the front of the abdomen which is made using surgery. It diverts faeces or urine into a pouch on the outside of your body). The practice had worked jointly with the PPG to provide health promotion through local events such as healthy eating, a PPG 3rd birthday fun party and a festival at Easter time. The practice had plans to move to bigger premises and the PPG was involved with the plan.

The areas where the provider should make improvement are:

• Review and embed systems for prescriptions security and infection prevention and control.
• Ensure plans to improve communication with patients who are deaf or hard of hearing are implemented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Tollgate Medical Centre on 9 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.