Tong Medical Practice

Updated 28 September 2022

Tong Medical Practice is located in Bradford at:

2 Procter Street

Bradford

West Yorkshire

BD4 9QA

The practice operates from a purpose-built health centre. It shares this site with another GP surgery, and an independent pharmacy. The surgery is situated in an accessible location with nearby public transport routes and has its own car park.

The provider is registered with CQC to deliver the Regulated Activities; surgical procedures, diagnostic and screening procedures, maternity and midwifery services, family planning and treatment of disease, disorder or injury.

The practice is situated within the West Yorkshire Health and Care Partnership Integrated Care System (ICS) and delivers Personal Medical Services to a patient population of about 8,600.

The practice is part of a wider network of GP practices as part of the BD4+ Primary Care Network (PCN). This comprises a partnership of local GP practices who work together to improve patient care.

Information published by Public Health England shows that deprivation within the practice population group is in the lowest decile (one of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 85% White, 7% Asian, 4% Black, 3% Mixed, and 1% Other.

Tong Medical Practice is operated by a single GP provider. They have a clinical team of three salaried GPs, three long-term locum GPs, one advanced nurse practitioner, one lead nurse, three practice nurses, two healthcare assistants and a practice pharmacist. The practice also receives additional staffing support from their PCN, this includes pharmacists, a paramedic, a first contact physiotherapist, a care coordinator, a mental health practitioner and a social prescriber. These clinical and service delivery staff are supported by a full-time business manager and a team of reception and administration staff.

The practice is open between 8am to 6pm Monday to Friday. The practice offers a range of appointment types including urgent, book on the day, pre-bookable advance appointments, and home visits. Appointments can be made via telephone, online, or directly by NHS 111.

Support is provided locally by Local Care Direct Limited between 6pm to 6:30pm Monday to Friday, and extended access appointments are provided by Bradford Care Alliance CIC, where late evening and weekend appointments are available. Out of hours services are provided by Local Care Direct Limited.

Updated 28 September 2022

We carried out an announced inspection at Tong Medical Practice on 17 and 18 August 2022. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspections undertaken in February 2015 and December 2019 the practice was rated outstanding overall. At the 2019 inspection, the key questions in relation to caring and responsive were rated as outstanding, with safe, effective and well-led rated as good.

At this inspection, we found that those areas previously rated as outstanding regarding the provision of caring and responsive services were now rated as good. This was due to a number of reasons which included mixed patient satisfaction with the provision of services. Some services previously seen as outstanding, had now been mainstreamed across other GP practices, or were now delivered in partnership with other providers.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Tong Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

This was a comprehensive inspection which was undertaken due to a change in the registration status of the location.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews face to face, and by using video/telephone conferencing.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing feedback from patients and members of the Patient Participation Group.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• Undertaking a short site visit.
• Reviewing completed staff questionnaires.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We found that:

• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• The management team ensured that care and treatment was delivered according to evidence-based guidelines.
• Procedures were in place to take action in respect of patient safety and medicines alerts.
• Clinical supervision and support for non-medical prescribers was in place, however this was on an informal and ad hoc basis.
• The practice adjusted how services were delivered to meet the needs of patients during the COVID-19 pandemic.
• There was a programme of quality improvement, this included clinical audit.
• Staff had the skills, knowledge and experience to deliver effective care. The practice had a strong training ethos and had supported a number of staff in the development of their professional careers.
• The practice operated effective systems and processes to ensure good governance in accordance with the fundamental standards of care. We saw that performance monitoring was embedded within the practice.
• The management team in the practice demonstrated they had the capacity and skills to deliver high-quality, sustainable care.
• The practice hosted a number of staff from their Primary Care Network who delivered enhanced services such as mental health support and care coordination.

We saw areas of outstanding practice:

• The practice had begun to operate an opioid reduction service in partnership with an external partner (an opioid is a substance used to treat moderate to severe pain). This operated on a half day a week basis and this was planned to expand to one day a week. Data shared with us showed that the first clinics had engaged with 24 patients and had led to eight of these either stopping or reducing their opioid usage.
• The practice either actively worked with other partners, or had developed plans to work with partners to deliver a number of programmes and services to improve the health and wellbeing of patients. These included:
  • Working with a local voluntary and community sector provider to deliver a range of programmes to improve service user wellbeing, and to tackle community issues such as social isolation. The practice had helped to develop and support this service and the lead clinician was a Director of the organisation.
  • The practice had continued to support patients who had been subject to, or at risk of domestic violence. In the last two years staff had made 941 routine enquiries with patients into domestic violence, and had referred ten patients on for further support.

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

• Continue to monitor and make improvements to increase the uptake of cervical screening and child immunisations.
• Formalise clinical supervision practices for non-medical prescribers.
• Fully establish the immunity status of staff in line with national guidance.
• Continue to implement measures to improve capacity, access to services, and patient satisfaction. In addition, continue to implement measures to improve patient engagement and feedback.
• Gain assurance that staff have access to a Freedom to Speak Up Guardian, and ensure staff are aware who they are and how to contact them.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services