Sunderland GP surgery rated Inadequate and placed into special measures by CQC

England’s Chief Inspector of General Practice has rated a Sunderland GP surgery as Inadequate and placed the practice into Special Measures following an inspection by the Care Quality Commission.

A specialist team of inspectors rated the service provided by Hylton Medical Group as inadequate for providing services that were safe, effective and well-led. They were also rated requires improvement for being caring and good for providing services that were responsive to people’s needs. The practice has been given an overall rating of inadequate.

Under CQC’s new programme of inspections, led by Professor Steve Field, Chief Inspector of General Practice, all of England’s GP practices are being inspected and given a rating.

The practice was inspected in April 2015 by an inspection team which included a GP, a practice manager and a specialist advisor with a practice management background. A full report of this inspection has been published on the CQC website today.

Although inspectors received positive comments from patients during the inspection who said that they were treated with dignity and respect by staff, CQC inspectors also identified a number of significant concerns.

Inspectors found a lack of effective systems in place to monitor the safe running of the practice. Systems were not robust, safeguarding events were not always shared with the relevant external agencies, and a limited number of clinical audits were being undertaken to improve patient outcomes.

The GP’s were found to be working hard to meet patients’ needs however the difficulties they had experienced during the previous 12 months before they managed to recruit a second GP partner had led to a high usage of locum GPs which had affected the continuity of care provided to patients as well as the cancellation of a number of appointments, although this was set to improve with the appointment of a new GP partner.

Concerns were identified in relation to recruitment procedures at the practice as appropriate checks on staff had not been undertaken prior to their employment and some staff engaging in the chaperone service had not been checked through the Disclosure and Barring Service (DBS) or undertaken the appropriate training.

Although clinical staff understood the need to gain consent from patients before providing treatment and the practice had a policy outlining guidance to staff on gaining consent from those who lacked capacity to do so, records indicated that the senior partner had not undergone specific training or learning covering the use of the Mental Capacity Act 2005.  

Whilst both GPs had a clear vision and development strategy for the practice, this was not shared amongst the team and was not informed by the views and contributions of all staff. However the recent appointment of the new GP partner had resulted in changes. There was also no evidence the practice manager had an effective development plan in place although they had taken it upon themselves to obtain the support needed from a colleague in another practice.

The Care Quality Commission has identified a number of areas for improvement, including:

• The practice must ensure adequate GP cover is maintained at all times to meet the needs of patients and avoid the cancelling of patient appointments;
• The practice must ensure staff are appropriately supported to carry out their roles and responsibilities. In particular, ensure all staff receive regular supervision and appraisals;
• The practice must carry out the required pre-employment checks for new partners and staff;
• The practice must ensure suitable arrangements are in place to assess, monitor and improve the quality and safety of the services provided. In particular, undertake clinical audits to demonstrate improvements in patient care and, review and update clinical guidelines to ensure patients receive the most effective care and treatment available;
• The practice must ensure all clinical staff receive training in the use of the Mental Capacity Act (2005).

CQC is working closely with Sunderland Clinical Commissioning Group and NHS England to support the practice while it addresses the issues identified by the inspection.

Sue McMillan, Deputy Chief Inspector of General Practice said:

“It is important that the Hylton Medical Group recognise the areas for improvement. Whilst we are aware that the practice has had considerable difficulties recruiting a new GP partner that affected the number of appointments available and disrupted continuity of care to patients there were additional concerns that included not being able to adequately meet the needs of patients and to plan the care required in line with best practice.

“Further concerns involved not ensuring that all staff employed were suitable to work with vulnerable adults and children.

“Immediate action must be taken in light of these findings so that the people registered there get safe, high-quality primary care, which everyone is entitled to receive from their GP.

“I do not believe that the practice is likely to resolve its challenges without external support. This is why we are placing the practice into special measures. 

“After a period of six months we will inspect again to check whether sufficient improvements have been made. If we find that the service provided by this practice remains inadequate, we will consider taking steps to cancel its registration with CQC.”

Patients registered with the practices being placed into special measures should be aware that the package of support being offered by NHS England and the Royal College of GPs will ensure that there are no immediate risks to patient safety at these GP practices whilst improvements are being made.

Ends

For further information please contact CQC Regional Communications Officer Mark Humphreys on 0191 233 3519.

For media enquiries about the Care Quality Commission, please call the press office on 020 7448 9401 during office hours. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here (please note: the duty press officer is unable to advise members of the public on health or social care matters). For general enquiries, please call 03000 61 61 61.