Archived: Ragstone Road Surgery

Letter from the Chief Inspector of General Practice

This inspection was a short notice announced focused inspection carried out on 5 April 2017 in response to information of concern received by CQC since February 2017. The practice had received a comprehensive inspection in June 2016 and this was followed up with a desk based exercise in February 2017. The practice was rated good following these previous inspections. The full comprehensive report, and shorter desk top review report, following the inspection on 16 June 2016 can be found by selecting the ‘all reports’ link for Ragstone Road Surgery on our website at www.cqc.org.uk.

The information received by CQC indicated:

• Inconsistent response to patient requests for a call from a practice GP.
• Information received from external sources was not being entered into patient records in a timely manner.
• The practice was not being kept tidy and clean.
• Test results were not being followed up in a timely manner.

We also reviewed how the practice responded to complaints. CQC had, in the previous four months, received copies of complaints lodged with the practice.

We have not updated the ratings for the practice as this inspection focused on specific areas of service delivery and the concerns raised.

Our key findings were as follows:

• Entry of clinical information into patient records was undertaken in a timely manner by appropriately trained staff.
• GPs called patients back on the day the patient requested to be called. Records of the return call were kept and these identified action required from the telephone consultation.
• Medical test results and correspondence from other providers of care and treatment were reviewed by the GP on duty on the day they were received. The action identified from correspondence and results was clearly documented and actioned either immediately or on the day following receipt. Records showed that the GPs clearly identified the urgency for action to be taken.
• The practice was kept clean and tidy. However, two disposable curtains around an examination couch had not been replaced in accordance with the practice replacement schedule.

The provider should:

• Ensure disposable curtains in clinical rooms are replaced every six months.

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 Ragstone Road Surgery on 30 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 Ragstone Road Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 8 February 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 on 30 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection. Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had reviewed their policies and procedures for patient reviews and was working to improve exception reporting figures. A GP had been appointed lead for QOF and was reviewing exception reporting. Improvements had been made and exception reporting had reduced with only diabetes and hypertension clinical indicators remaining above local and national averages.

• The practice had increased their communication with patients being offered health screening to improve uptake. They had asked the patient participation group to update the practice newsletter and promote patient engagement in their health. Cervical smear rates had increased from previous years, but remained below the local and national average.

• The practice had reviewed patient feedback and undertaken their own patient satisfaction surveys. Improvements had been made, although patient satisfaction scores from the GP national survey remained below local and national average for many aspects of care.

• Governance arrangements had taken into account the previous inspection report findings and the practice had engaged with staff and patients to improve outcomes.

During our inspection in June 2016 we highlighted a lack of awareness of extended hours services and availability to patients. The practice had put notices up in the waiting area and on the practice website to inform patients of these.

However, there were also areas of practice where the provider should make improvements;

• Continue to review patient feedback and work to improve patient satisfaction scores.

• Monitor exception reporting and continue to promote patient engagement in health screening and reviews to improve current figures.

• Continue to monitor and improve patient uptake of health screening through the national screening programme. In particular, cervical smears and bowel cancer screening.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice