City View Medical Practice

We carried out an announced focused inspection of City View Medical Practice on 12 March 2020, following our annual review of the information available to us, including information provided by the practice. This inspection focused on the following key questions:

• are services effective
• are services well-led.

Because of the assurance we received from our review of information, we carried forward the ratings for the following key questions:

• are services safe (good)
• are services caring (good)
• are services responsive (good).

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

• what we found when we inspected
• information from our ongoing monitoring of data and about services
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall. We have rated the population group working-age people (including those recently retired and students) as being requires improvement for effective because:

• Cancer screening uptake rates, particularly those for cervical screening, were below local and national averages.

Our key findings at this inspection were:

• The practice had responded to the challenge of COVID-19 and were effective in identifying patients who were at risk and signposting them to appropriate services.
• Staff were engaging with patients, and providing information for, patients whose first language was not English.
• A review of care and screening available for transgender patients had been undertaken, to ensure they were supported to access care in line with their choice.
• The practice employed a mental health nurse specialist to support those patients with complex mental health needs and minimise the risk of them entering a ‘crisis’ phase.
• The practice participated in a range of quality improvement schemes to support patient services.
• The practice patient participation group was committed to supporting patients, particularly with health lifestyle interventions, such as raising cancer screening awareness and organising the practice allotment.
• There was evidence of effective leadership and management. Leaders and managers had a good understanding of the challenges they faced regarding the provision of primary care services for their patient population.
• Patients were generally positive about the care, treatment and service they received.
• The merger of two locations had been successful in minimising any inconvenience to patients, whilst supporting staff through the process.

There was one area of outstanding practice:

• The practice had an allotment which the patient participation group supported patients to become involved in the maintenance of. The allotment was used to promote the health and wellbeing of patients. Produce grown in the allotment was made available in the practice for patients.

The areas where the provider should make improvements are:

• Continue to encourage and improve uptake rates for childhood immunisations.
• Continue to encourage and improve uptake rates for cancer screening programmes, particularly those relating to cervical screening.
• Improve and reduce the exception reporting relating to the Quality and Outcome Framework long-term condition indicators, to support patient care.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care