The Care Quality Commission
  • Doctor
  • Out of hours GP service

Suffolk GP Federation C.I.C. - Head Office

Overall: Good read more about inspection ratings

Riverside Clinic, 2 Landseer Road, Ipswich, Suffolk, IP3 0AZ 0845 241 3313

Provided and run by:
Suffolk GP Federation C.I.C.

Important: The provider of this service changed. See old profile

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Suffolk GP Federation C.I.C. - Head Office on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Suffolk GP Federation C.I.C. - Head Office, you can give feedback on this service.

22 April 2022

During an inspection looking at part of the service

We carried out an announced desk-based review of Suffolk GP Federation C.I.C. - Head Office on 22 April 2022. Overall, the practice is rated as Good.

Set out the ratings for each key question

Safe - Good

Effective – Not inspected

Caring - Not inspected

Responsive - Not inspected

Well-led - Not inspected

At our previous inspection on 23 June 2021, the practice was rated Good overall and for providing effective, caring, responsive and well-led services but requires improvement for providing safe services. We found a breach of regulation relating to improvements which needed to be made to the system for monitoring oxygen availability across the GP+ and Out of Hours sites.

The areas where the provider should make improvements were:

  • Continue with plans to include relevant equipment used but not owned by the provider, as part of their calibration programme.
  • Continue work to document the Hepatitis B vaccination status of clinical staff.
  • Confirm, in writing, information given to patients verbally in response to complaints raised.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Suffolk GP Federation C.I.C. - Head Office on our website at www.cqc.org.uk

Why we carried out this review

This desk-based review was to follow up on the breach of regulation and areas where the provider ‘ ‘should’ improve which were identified at our previous inspection. We found the required improvements had been made and the practice is now rated as good for providing safe services.

How we carried out the review

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 reviews differently.

This review was carried out remotely. This was with consent from the provider and in line with all data protection and information governance requirements.

This included

  • Conducting staff interviews using video conferencing
  • Requesting evidence from the provider

Our findings

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

  • what we found when we obtained new information from the provider
  • 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:

  • The service had clear systems to keep people safe and safeguarded from abuse.
  • The service had reliable systems for appropriate and safe handling of medicines.
  • The service took complaints and concerns seriously and responded to them appropriately to improve the quality of care. At our previous inspection, one of the complaint responses we reviewed did not include information about the Parliamentary and Health Service Ombudsman (PHSO) and another complaint was dealt with by telephone and PHSO information was given verbally but had not been documented. At this inspection, we saw evidence that all complaints handled verbally were followed up with a written communication which included the PHSO information.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

04 June 2021, 7 June 2021, 9 June 2021, 14 June 2021

During a routine inspection

This service is rated as Good overall. (At the previous inspection, published 15 March 2019, the service was rated requires improvement overall.)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

Following our previous report published March 2019, Suffolk GP Federation C.I.C. - Head Office was rated requires improvement overall and for providing safe, effective and well led services. The ratings for caring and responsive services were good. The full reports for previous inspections can be found by selecting the ‘all reports’ link for Suffolk GP Federation C.I.C. Head Office on our website at www.cqc.org.uk

We carried out an announced comprehensive inspection of Suffolk GP Federation C.I.C. – Head Office, as part of our inspection programme on 4, 7, 9 and 14 June 2021. This was to follow up on the requirement notices for Regulation 12 and Regulation 17 issued at the previous inspection and to inspect the Suffolk GP Out of Hours service which Suffolk GP Federation C.I.C. (the provider) had taken responsibility for providing since April 2019.

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:

  • Requesting and reviewing evidence from the provider
  • Reviewing patient records
  • Conducting staff interviews using video conferencing and by telephone
  • Reviewing staff questionnaires
  • Requesting feedback from other stakeholders and patients who use the service
  • Short site visits

At this inspection we found:

  • The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
  • Improvements had been made to infection control, prescription stationery security, availability and calibration of equipment, and emergency medicines were stocked in line with current guidelines. However, we found three weighing scales at the Riverside site which had not been calibrated and improvements were needed to the system for monitoring oxygen availability across the GP+ and Out of Hours sites.
  • The service routinely reviewed the effectiveness and appropriateness of the care it provided. Systems were in place to keep clinicians up to date with current evidence-based practice and the provider had an ongoing programme of audits to check evidence-based practice was followed. Templates were in place at the minor injury unit which enabled a detailed history, assessment, clinical observations, examination, treatment and advice to be documented. Work had been undertaken to identify competencies for clinical staff and there were systems to ensure all staff were competent to do their role.
  • Staff involved and treated people with compassion, kindness, dignity and respect.
  • Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
  • Arrangements were in place to respond in a timely way to complaints, however, although information to escalate a concern to the Parliamentary Health Service Ombudsman was available for patients, it was not always documented that this had been provided to patients who made a complaint. The service took complaints and concerns seriously and learnt from them to improve the quality of care.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation. Feedback from staff demonstrated they felt supported and were proud to work for the service. The service was involved in a range of pilot projects and initiatives.
  • The provider had made significant improvements to address concerns raised at our previous inspection, however a new concern was identified during this inspection and the actions the provider has taken to address the concern required further monitoring, review and embedding to ensure they were effective.

We saw two areas of outstanding practice:

  • Following proactive analysis of the needs of patients who may use the Felixstowe minor injury clinic service, a range of comprehensive templates had been developed in response to those areas. These included for example, minor injury, eye injury, head injury assessment, musculoskeletal injury and neurological examination. These templates ensured a full assessment of the patient’s needs, including a set of baseline clinical observations, had been completed. When this service had changed from a walk in centre (no pre-booked appointments necessary) to a walk in clinic (pre booked appointments only) the service manager contacted the council to change all the signage in the local area so patients were no longer directed to this facility, but the nearest hospital in Ipswich.
  • The North East Essex Diabetes services (NEEDS) were a Quality in Care Diabetes 2020 award winner for their emotional wellbeing programmes for people with diabetes. The team collaborated with the local health in mind/improving access to psychological therapies (IAPT) team to improve access, care and treatment. Initially IAPT therapists were invited to diabetes patient education events, but this led to other developments, for example, new clinics and a diabetes and well-being course. The service includes fast track appointments, with upskilled practitioners in a familiar location. An audit from June to August 2020 analysed caseload trends of the mental health practitioner within NEEDS. It identified the average patient contacts were five per day, with referrals mainly from GP practices, diabetes specialist nurses and from secondary mental health teams asking for additional support. Integrating support from NEEDS with psychological care from IAPT, helped to break down barriers for diabetes patients accessing medical care which resulted in improved glycaemic control and reduced psychological stress. A survey was sent to 90 patients who had used the service from November 2019 to September 2020 of which 14 patients responded. 78% of patients reported the contacts were helpful, 86% felt listened to and supported, 100% were treated with dignity and respect, and 72% felt the contact had helped with their diabetes management.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Continue with plans to include relevant equipment used but not owned by the provider, as part of their calibration programme.
  • Continue work to document the Hepatitis B vaccination status of clinical staff.
  • Confirm, in writing, information given to patients verbally in response to complaints raised.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

21 January to 29 January 2019

During a routine inspection

This service is rated as Requires improvement overall. (Previous inspection October 2013, the provider was compliant with the regulations but was not rated at this inspection.)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

  • We carried out an announced comprehensive inspection at the Suffolk GP Federation C.I.C. as part of our inspection programme on 21, 22, and 29 January 2019. Suffolk GP Federation C.I.C is a community interest company and is the registered provider of three other locations and services are provided from various sites across Suffolk and North East Essex. Suffolk GP Federation C.I.C. holds contracts with Ipswich and East Suffolk, West Suffolk and North-East Essex Clinical Commissioning Groups (CCGs).

At this inspection we found:

  • The Suffolk GP Federation C.I.C was a clinically led organisation and leaders had the capacity and skills to deliver high-quality, sustainable care. We found at senior level the leadership was clear, organised and proactive but this did not always ensure that the leadership at local levels was effective for example we identified risks to patients at the minor injuries unit.
  • We found the records of some patients seen at the minor injuries unit did not contain sufficient detail to evidence that patients had been fully assessed. The management team took immediate action and reviewed the records, contacted patients as appropriate and told us they would implement new systems to address this issue.
  • The service had systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes. The service used various ways to communicate with both regular and sessional staff such as regular emails, newsletter and electronic notifications and staff were responsible for reading communications issued to them. However, not all staff we spoke with during our inspection were aware of the learning shared.
  • We found the service had systems and processes to manage risks to patients but not all of these were fully known or understood by staff working in the local sites where services were delivered. For example, not all staff working at the various locations we inspected were clear about the IPC process and their responsibilities.
  • Although the provider had risked assessed the provision of emergency medicines to ensure they were easily available to staff in the event of a medical emergency, the medicines in stock were not in line with the current guidelines and the mitigation of risk for some medicines was insufficient to ensure patients would receive emergency treatment in a timely manner. The Suffolk GP Federation C.I.C. reviewed their assessment immediately and updated to provide additional medicines.
  • The emergency department streaming service provided care and treatment within service guidelines and timescales. The provider worked closely with emergency department partners to continually evaluate and improve the service, including effective safety protocols in place to manage patients who needed to be referred back into the emergency department.
  • The GP+ service provided patients with timely access to evidence based care and treatment based on their needs. Staff felt well supported and there was good cross site working to effectively manage capacity and demand.
  • The service routinely reviewed the effectiveness and appropriateness of the care it provided; however, we found in the minor injuries unit these reviews did not always address issues in the way care and treatment was recorded.
  • We found that staff were knowledgeable about their service but the provider did not have clear and easy oversight that all staff were competent to do their role. We found in some areas such as the minor injuries unit and the cardiology clinic there was a lack of oversight to be assured that all staff had been fully assessed as competent to do their roles.
  • Staff involved and treated people with compassion, kindness, dignity and respect.
  • Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
  • Patients we spoke with and the results from the friends and family test gave positive feedback about the care and treatment they had received.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation. We saw examples of clinical and non- clinical staff having access to further development including leadership programmes.

We saw areas of outstanding practice:

  • In October 2018, the north-east Essex diabetes services (NEEDS) had won a national award in recognition of its clinical excellence at the recent Quality in Care Diabetes award, winning the category for the best adult diabetes education programme. The Suffolk GP Federation C.I.C was also highly commended in the ‘Best Practice and Sustainability’ category for their integrated approach which had improved patient outcomes. The provider continuously and proactively monitored the diabetic service they offered. Regular reports and audits were shared with the North Essex CCG who confirmed they had no concerns about the high level of service offered. Regular audits had been completed such as the number of patients completing the patient education programmes and the monitoring of patients’ blood test results. The CCG analysed the progress of the diabetes quality and outcome (QOF) indicators for the North-East Essex practices comparing 2015/2016 data to 2016/2017 data. This concluded an improvement was seen in eight of the ten QOF indicators. The service saw an average of 1000 patients per month through the year January to December 2018.
  • The falls and fragility service is a small service offered by specialist’s nurses in the community. It was set up six years ago to ensure patients across West Suffolk had equitable access to advice and support. The service gave patients a personalised service with a long term aim to reduce fractures in the age group of over 60 years old. CCG data showed that from April 2018 to November 2018 the service had seen 332 patients. Nationally published data showed that as a result of their approach and follow up the patients they saw were more compliant with their medicines with an 80% compliance compared with the national average of 32%.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

22 March 2013

During a routine inspection

We visited the provider's headquarters to look at records and meet with the registered manager and four staff members. Following this we visited the Head Office location where a cardiology clinic was being held on the afternoon of our inspection.

We spoke with two people who were attending appointments at the cardiology clinic. We also spoke with two people's relatives. People told us that they were happy with the information that they had received during their appointment. One person said, "They were very informative and have put my mind at ease." Another person said, "We were given the information that we needed."

People told us that they were provided with information about their appointments and where they were being held. One person said, "I thought I would have had to go to the hospital, but I was happy to come here as it is much closer to home." Another person showed us their appointment letter which included the time and address of their appointment.

People said that they were not kept waiting for their appointment. One person said, "We were seen straight away." Another person said, "I came in early and thought I would have to wait, but they called me straight in."

We found that staff were provided with the training that they needed to meet the needs of the people who used the service. The provider had an effective system to regularly assess and monitor the quality of service that people received.