Wilson Street Surgery

We carried out an announced comprehensive inspection at Wilson Street Surgery on 6 and 9 October 2023. Overall, the practice is rated as good. We rated the practice as good for providing safe, effective and caring services, requires improvement for providing responsive services and outstanding for providing well-led services. The CQC recognises the pressure that practices are currently working under and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by patients’ needs and experiences of care. Although we saw the practice was attempting to improve access, this was not yet reflected in the GP National Patient Survey data or other sources of patient feedback.

At our previous inspection on 9 March 2016, the practice was rated outstanding overall and for the key questions effective and responsive. They were rated good for the key questions safe, caring and well-led. We rated the practice as outstanding for providing effective and responsive services because:

• Quality and outcome indicators showed patient outcomes were at or above average compared with national averages. The practice demonstrated a strong track record of effective prescribing including ensuring low rates of antibiotic prescribing.
• The practice demonstrated a strong commitment to improving access to healthcare for people who were vulnerable.

At this inspection, we found that the practice had continued to demonstrate a strong and innovative commitment to improve access to healthcare for people who were vulnerable. However, due to poor patient satisfaction, as demonstrated in the GP National Patient Survey, regarding access to appointments the threshold to achieve an outstanding rating for providing responsive services had not been reached. The practice is therefore now rated good for providing effective services and requires improvement for providing responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Wilson Street Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

• We inspected the key questions safe, effective, caring, responsive and well-led.
• We followed up on the best practice recommendation that the practice should continue to review telephone access for patients to improve the ease of patients contacting the practice by telephone.

How we carried out the inspection.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit.
• Speaking with a representative of a care home where the provider provided care and treatment.

Our findings

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 and
• information from the provider, patients, the public and other organisations.

We rated the provider as Good for providing safe, effective and caring services because:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice provided additional in-house services to reduce the workload on secondary care services and could demonstrate the positive impact of these services.
• The provider pioneered initiatives that focused on identifying and improving care for moderately frail patients.

We rated the practice as Requires Improvement for providing responsive services because:

• Patient satisfaction with telephone access to appointments was below the national average.

We rated the practice as outstanding for providing well-led services because:

• There was dynamic, compassionate, inclusive and innovative leadership in place which drove improvements in the delivery of high quality person-centred care. This included collaborative partnerships, multidisciplinary and multiagency working which tackled health inequalities. The provider could clearly demonstrate the positive impact this had on health outcomes for under-represented populations such as homeless people, asylum seekers, frail patients and those struggling with the cost of living crisis.
• Leaders embraced innovations and proactively sought out and embedded new ways of working to provide care and treatment to its diverse population. Equality, diversion and inclusion underpinned all of this work.
• Staff feedback was highly positive about the support provided to staff and staff were proud to work at the practice.

Whilst we found no breaches of regulations, the provider should:

• Update the infection control and prevention audits and action plans to include the need to replace the carpet, sink and taps in consultation rooms where these had not been updated.

• Continue to embed into practice strategies to increase the uptake rate of childhood immunisations and cervical screening.
• Continue to review and drive improvements to increase patient satisfaction with telephone access to appointments.
• Include details of the Integrated Care Board (ICB) and Parliamentary and Health Service Ombudsman (PHSO) in the complaint response letters to patients so they are informed of who to contact if they are unsatisfied with the results of the complaint investigation.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care