The Project Surgery - Care Quality Commission

Background to this inspection

Updated 7 August 2017

The Project Surgery is a GP practice located in Plaistow in the east end of London. Plaistow is a town in the London Borough of Newham and the practice is a member of the Newham Clinical Commissioning Group (CCG). The practice is housed within a purpose built building situated within a large housing estate. It is easily accessible by public transport and by car, although parking on surrounding streets is limited.

The Project Surgery is registered with the Care Quality Commission to provide the following regulated activities from 10 Lettsom Walk, London, Newham E13 0LN: Treatment of disease, disorder or injury; Family planning; Maternity and midwifery services; Diagnostic and screening procedures. Services are provided under a Personal Medical Services contract (a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract) to approximately 4500 people living in Newham.

Newham’s population is one of the most ethnically diverse in London. In 2009, 65% of residents were recorded as being non-white. Of these 21% were Pakistani or Bangladeshi, 18% were Black, 11% were Indian and 14% were either of mixed ethnic origin or from another non-white ethnic group. The population distribution of the practice area shows a higher than average proportion of patients aged 20 to 44.

Newham residents have lower life expectancy and higher rates of premature mortality than other Boroughs in London and the average for England as a whole. The main causes of death in Newham are cardiovascular disease, cancer and respiratory disease and the levels of diabetes are among the highest in the country. Newham is the third most deprived local authority area in England. The area has a higher percentage than national average of people whose working status is unemployed (13% compared to 5% nationally) and a lower percentage of people over 65 years of age (7% compared to 17% nationally). The practice’s locality is in the second most deprived decile out of ten on the deprivation score.

The practice was set up in 2003 as a community surgery with funding from the urban regeneration fund at the request of residents. The practice is staffed by a principal GP (female, providing five sessions per week), three salaried GPs (all female, working a total of 15 sessions per week), an advanced nurse practitioner, a practice nurse and a healthcare assistant (all female). Non-clinical roles included a practice manager, a reception manager and three reception/administrative staff, all of whom worked part time.

The practice is a training practice, although there were no trainee GPs at the time of our inspection.

The practice is open from 8am to 6pm Monday to Friday. Surgery times are from 9am to 12pm and then 3pm to 6pm every day except Monday when the surgery time starts at 8.30am and Friday when it ends at 6.30pm. The practice operates extended hours from 6.30pm to 9pm every weekday except Thursday when extended hours are from 2.30pm to 9pm and from 9am to 1pm on Saturday and Sunday in conjunction with other local practices. Outside of these hours patients were directed to the local urgent care centre or the NHS 111 service.

Overall inspection

Good

Updated 7 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The project Surgery on 15 August 2016. The overall rating for the practice was good. The full comprehensive report on the 15 August 2016 inspection can be found by selecting the ‘all reports’ link for The Project Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 14 July 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 15 August 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:

There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
The practice had clearly defined and embedded systems to minimise risks to patient safety.
Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
The practice had good facilities and was well equipped to treat patients and meet their needs.
There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
The provider was aware of and complied with the requirements of the duty of candour.

At our previous inspection on 15 August 2016, we rated the practice as requires improvement for providing safe services.

The registered person failed to have systems and processes established and operated effectively to enable them to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk which arise from the carrying on of the regulated activity, specifically in relation to the safe storage and management of vaccines.

At this inspection we found that the practice had implemented systems to ensure patients safety and had provided evidence to prove this.

Consequently, the practice is now rated as good for providing safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice