Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Victoria Road Medical Centre on 16 June 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Victoria Road Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 31 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection on the 16 June 2016.

Overall the practice is rated as Good.

Our key findings were as follows:

• During our previous inspection we saw that administrative staff processed letters received from other organisations such as hospitals and forwarded those requiring action to the GP. However, there was no clinical oversight in place ensure that triage and actions were appropriate and safe. At this follow up inspection we saw this had been reviewed and a safer process introduced.

• When we inspected the practice in June 2016 we saw performance for mental health related indicators was lower compared to local and national averages. The practice reviewed this and the most current published data showed improved achievement for mental health indicators.

• When we inspected the practice in June 2016 results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was lower compared to local and national averages, particularly around telephone access. The practice had employed administration staff which resulted in 20 hours additional reception support during peak times. It also allowed the practice more flexibility as shifts could be changed to match demand.

• Plans were in place to install a new telephone system that will provide a live feedback of demand (the number of calls waiting and the number of dropped call) through an information board enabling the practice to better match resources to demand.

In addition the provider should:

• Ensure ongoing quality improvement strategies can demonstrate positive impact on access to appointments.

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 Victoria Road Medical Centre on 16 June 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Victoria Road Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 31 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection on the 16 June 2016.

Overall the practice is rated as Good.

Our key findings were as follows:

• During our previous inspection we saw that administrative staff processed letters received from other organisations such as hospitals and forwarded those requiring action to the GP. However, there was no clinical oversight in place ensure that triage and actions were appropriate and safe. At this follow up inspection we saw this had been reviewed and a safer process introduced.

• When we inspected the practice in June 2016 we saw performance for mental health related indicators was lower compared to local and national averages. The practice reviewed this and the most current published data showed improved achievement for mental health indicators.

• When we inspected the practice in June 2016 results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was lower compared to local and national averages, particularly around telephone access. The practice had employed administration staff which resulted in 20 hours additional reception support during peak times. It also allowed the practice more flexibility as shifts could be changed to match demand.

• Plans were in place to install a new telephone system that will provide a live feedback of demand (the number of calls waiting and the number of dropped call) through an information board enabling the practice to better match resources to demand.

In addition the provider should:

• Ensure ongoing quality improvement strategies can demonstrate positive impact on access to appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We undertook this follow up visit in response to concerns that we had identified during our previous inspection of the service in July 2013. Our visit was discussed and arranged with the provider in advance so that any disruption to people’s care and treatment were minimised.

At our previous inspection we identified that the provider did not have effective systems in place for monitoring the quality of the service that the practice delivered. At the time of the inspection we judged that this had a moderate impact on people who used the service and asked the provider to take action. Following the inspection in July 2013, the provider sent us an action plan which set out how they would address the issues raised.

During this inspection we spoke with the practice manager, a GP and a practice nurse. We also reviewed various documents that were made available to us. We found that the provider had taken appropriate action to improve the service patients received.

Systems had been put in place to support learning from complaints and incidents and ensure action was taken to improve the service that patients received. Audits were used to identify areas for service improvement.

On the day of our inspection we spoke with six patients and six members of staff. One patient told us, "I am happy with the service I get here, I have no complaints." Five out of the six patients we spoke with said they were able to obtain appointments at a time to suit their needs and that they did not have to wait long once they arrived at the practice.

We saw that patient's views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. One patient told us, "They very much treat you with respect." We saw that patients experienced care and treatment that met their needs. Patients told us and we saw that care was delivered in a clean environment.

The staff we spoke with were knowledgeable about safeguarding vulnerable adults and children and we saw that they had received training on this.

The quality monitoring systems in place required improvement. Complaints and incidents had not been analysed to ensure learning and improvements to practice took place. There was a lack of audits to inform risk and necessary improvements required.