Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tudor Practice Stockland Green Limited on the 2 and 17 November 2016. The overall rating for the practice was good; however, the practice was rated as requires improvement for providing caring services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Tudor Practice Stockland Green Limited on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 7 February 2018 to confirm that the practice had carried out their plan to make improvements in relation to measures taken to improve patients’ satisfaction rates in areas such as patient involvement and access; as well as, improving measures to gain patient feedback and the uptake of national screening programmes. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• Members of the management team were aware of the issues regarding phone access and we saw evidence of actively communication with the Clinical Commissioning Group (CCG) to explore options regarding commissioning a more effective phone system. Staff explained that there was online appointment booking facilities and patients were also able to place repeat prescription requests using the online facilities. Staff continued to promote their website and social media pages to raise awareness regarding these options. Data provided by the practice showed 26% of patients were registered for online services; this was above the contract requirements’.

• There were variations in patient satisfaction rates in relation to access. For example, satisfaction with opening hours had improved by 1% since the 2016 survey; however, access to appointments showed a 15% decline. In response to the national GP patient satisfaction scores in relation to access staff explained the practice were no longer closed on a Thursday afternoon.

• Following the increased opening hours, in order to monitor patient satisfaction the practice had carried out a practice led survey between August and December 2017. Forty patients completed and returned a survey form. Data showed patients were satisfied with the practice opening times, getting through by phone and GP consultations.

• Staff explained that since our November 2016 inspection, they had continued efforts to set up a Patient Participation Group (PPG). For example, posters were located in the reception area; non-clinical staff actively spoke with patients discussing the benefits of joining the PPG. As a result, the practice recruited five active members and were holding regular meetings to discuss areas of improvement.

• The practice continued to encourage patients to engage with the cervical screening programme. For example, we saw posters in the reception area in a variety of languages. The practice sent out screening text reminders, appointment letters to women who missed three appointments and the clinical system identified patients which allowed GPs to proactively discuss the benefits of cervical screening during consultations’. The practice provided data taken from their clinical system which showed that uptake rates were 68% at the time of our inspection. We also saw evidence demonstrating all identified patients had been sent an appointment reminder letter.

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

In addition the provider should:

• Continue monitoring appointment and phone access to increase patient satisfaction.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tudor Practice Stockland Green on 2 and 17 November 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 assessed and well managed.
• The practice undertook continuous audit to improve patient outcomes.
• 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.
• Patients said they were treated with compassion, dignity and respect and staff were supportive.
• The practice had been unable to recruit a salaried GP and used long term locum GPs, this affected the continuity of patient care and involvement in decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs. 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.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• There was a clear leadership structure and staff felt supported by management. The practice sought feedback from patients via in-house surveys, which it acted on.
• The practice did not have a patient participation group and had undertaken various initiatives to encourage patients to participate.
• The provider was aware of and complied with the requirements of the duty of candour.

• There was a strong team culture and the practice was cohesive and organised.

However there were some areas where the provider should make improvements. The provider should:

• Continue to encourage patients to engage with the cervical screening programme.
• Continue to monitor measures taken to improve patient satisfaction rates in relation to involvement and access to appointments.
• Continue efforts to set up a patient participation group in order to engage with patients and capture their views.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice