Suffolk GP Federation C.I.C., is the registered provider of this service. Suffolk GP Federation C.I.C is a community interest company and is the registered provider of two other locations and services are provided from various sites across Suffolk.
Unity Healthcare, previously known as Clements, Kedington and Steeple Bumpstead Surgery is referred to in this report as ‘the practice’. The practice had taken on responsibility for Steeple Bumpstead Surgery from 31 October 2019, which became a branch site of the practice; this practice was rated inadequate overall in May 2019. Clements, Kedington and Steeple Bumpstead Surgery were previously called Christmas Maltings, Clements & Kedington Surgery.
The practice was previously inspected on 27 January 2019. The practice was rated inadequate for providing effective and well-led services, requires improvement for providing safe and responsive services and was rated good for providing caring services. This gave the practice an overall rating of inadequate and the practice was placed into special measures. The practice was issued with a warning notice for Regulation 17, Good governance. We carried out an announced comprehensive inspection on 21 August 2019 following six months in special measures. The practice was rated good for providing safe services, requires improvement for providing effective, caring and well led services and inadequate for providing responsive services. This gave the practice an overall rating of requires improvement and the practice remained in special measures.
We carried out an announced comprehensive inspection at the practice as the practice was in special measures. We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering how we carried out this inspection. We therefore undertook most of the inspection processes remotely and spent less time on site. We conducted staff interviews between 8 October to 15 October 2020 and carried out a site visit on 19 October 2020.
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 about services
• information from the emergency support framework call with the practice in June 2020 and
• information from the provider, patients, the public and other organisations.
We have rated this practice as requires improvement overall.
- Improvements had been embedded, with effective systems in place for medicines reviews, summarising and coding of medical records, prescribing, and the oversight of staff with extended roles.
- Patients received effective care and treatment that met their needs. Quality and Outcomes Framework (QOF) performance was now in line with and above the local and national averages. Systems were embedded to continue to monitor performance.
- Plans for improvement for the uptake of childhood immunisation and cervical screening were in place and performance was monitored monthly. Unverified data provided by the practice demonstrated an improvement in uptake in both these areas, with plans in place to continue to further improve.
- There was a culture of learning and support in the practice. The practice had been approved as a training practice for GPs with the Eastern Deanery.
We rated the practice as good for providing effective services. The population group working age adults was rated requires improvement because:
- Although the practice had worked to improve the uptake of cervical screening, this remained below the national target of 80%.
We rated the practice as requires improvement for providing caring services because:
Results from the National GP Survey results published in July 2020 had not improved. Although the practice had undertaken surveys of patients who had recent contact with the practice, this did not include the same questions to enable comparison. Some improvements had been made which were reflected in positive comments from patients, care home representatives and professionals and in surveys of patients who had recent contact with the practice demonstrated. These improvements needed to be sustained and embedded.
We rated the practice as requires improvement for providing responsive services because:
- We found that some areas of the National GP Survey results published in July 2020 had improved. Since the on the day total triage model had been in operation, the practice was able to evidence through their recent patient surveys, decrease in complaints and increase in compliments that patient satisfaction regarding access had improved. Satisfaction rates needed to be sustained and further improved. The practice planned to review the monitoring data for incoming telephone calls, to ensure it identified any issues from a patient’s perspective. This applied to all patients and therefore all population groups.
We saw one area of outstanding practice:
- The practice had been nominated for an NHS Parliamentary Award in the NHS futures category, due to their work in implementing eConsult, working with eConsult to improve the system and working with and sharing the system and learning with wider NHS organisations.
The areas where the provider should make improvements are:
- Continue work to monitor and further improve the uptake of childhood immunisations and cervical screening.
- Continue to monitor and embed improvements made in relation to timely access to care and treatment. This is to ensure improvements to patient satisfaction is sustained and further increased.
- Review how to improve the monitoring data for incoming telephone calls to further improve access.
This service was placed in special measures in January 2019. I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care