The Broadway Surgery

Background to this inspection

Updated 20 October 2017

The Broadway Surgery provides GP primary care services to approximately 6045 people living in Redbridge. 13% of are patients are over 65, which is higher than the Redbridge average of 12%.

The local area is a mixed community and there is a wide variation in the practice population, from relatively deprived to affluent.

The practice is staffed by two GP partners. In addition there are two salaried GPs. There is one male and three female GPs who work a combination of full and part time hours totalling 21 sessions per week. Other staff include a practice manager, a nurse, a health care assistant and ten administrative staff. The practice holds a General Medical Services (GMS) contract and was commissioned by NHSE London. The practice is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, treatment of disease,

disorder and injury, surgical procedures, family planning and maternity and midwifery services.

The practice was open between 8.30am to 6.30pm except on Mondays and Fridays when it opened at 8am and Fridays when it closed at 7.30pm. The telephones were staffed throughout working hours. Appointment slots were available throughout the opening hours. The out of hours services are provided by an alternative provider. The details of the ‘out of hours’ service were communicated in a recorded message accessed by calling the practice when closed and details can also be found on the practice website. Longer appointments were available for patients who needed them and those with long-term conditions. This also included appointments with a named GP or nurse.

Pre-bookable appointments could be booked up to two weeks in advance; urgent appointments were available for people that needed them.

The practice provided a wide range of services including clinics for diabetes, chronic obstructive pulmonary disease (COPD), contraception and child health care. The practice also provided health promotion services including a flu vaccination programme and cervical screening.

Overall inspection

Good

Updated 20 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Broadway Surgery on 8 June 2016. The overall rating for the practice was good, however the practice was rated requires improvement for the safe key question. The full comprehensive report on the 8 June 2016 can be found by selecting the ‘all reports’ link for The Broadway Surgery on our website at www.cqc.org.uk.

At the inspection on 8 June 2016 we found there were concerns about safety systems and processes in respect of background checks for staff, infection control, medicines management, fire safety and arrangements to deal with emergencies and major incidents.

These arrangements had significantly improved when we undertook a follow up inspection on 4 September 2017.

This inspection was an announced focused inspection carried out on 4 September 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 8 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice remains rated as good.

Our key findings were as follows:

Risks to patients were assessed and well managed. This included those relating to fire safety and staffing.
All staff undertaking chaperoning had undergone a Disclosure and Barring Service (DBS) check. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).
All staff had undergone infection control training. Funding and plans were in place to replace the carpets and chairs with those of a more suitable type for a clinical environment.
An increased number of urgent appointments were made available. The provider had taken action to respond to patient’s experiences concerning difficulty getting appointments.
The arrangements for managing medicines, including emergency medicines and vaccines, in the practice kept patients safe.
There were suitable arrangements to deal with emergencies and major incidents.

At the inspection on 8 June 2016 we said the practice should:

Review the telephone and booking system to ensure that patients are able to book appointments when needed and review the practice’s opening hours in light of patient feedback in the GP patient survey.
Implement processes to improve their immunisation rates for five year olds.
Ensure patients with caring responsibilities are proactively identified.

At the inspection on 4 September 2017 we found:

The practice had reviewed and adjusted its opening time on Mondays and Fridays so that on those days it opened at 8am, rather than 9.30am. It also now closed at 7.30pm on Fridays, rather than 6.30. The two partners were also doing an additional session on those days in order to increase appointment availability. In addition pre-bookable appointments (48 hours in advance) were now available in the mornings whereas previously they were only available in the afternoons.
Immunisation rates for five year olds had improved from 54% to 64% to 72% to 88%. Policies and procedures we in place to ensure control and oversight over performance in childhood immunisations.
Patients who were also carers were being identified, however it was unclear how effective the processes and procedures in place were. We saw notices on display in the waiting area. The new patient registration form was amended to include a question about whether or not the patient was a carer. At the inspection on 8 June 2016 the practice had identified 12 patients as carers (0.2% of the practice list). At this inspection we found 34 patients had been identified (0.3%).

The areas where the provider should make improvement are:

Take further steps to ensure the practice is able to respond appropriately in the event of an emergency by ensuring fire alarm checks are recorded and child pads for the defibrillator are obtained.
Continue to review and improve processes and procedures for the identification of patients who are carers to ensure they receive the necessary level of care and support.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice