22 October 2015
During an inspection looking at part of the service
Letter from the Chief Inspector of General Practice
We carried out an announced follow-up inspection of Hightown Surgery on 22 October 2015. This inspection was a follow-up to our inspection of 6 November 2014 when the practice was rated as ‘Inadequate’. The practice was placed into Special Measures in April 2015 and required to make significant improvements. The practice submitted an action plan detailing how they would make improvements and when they would be compliant with the regulations governing providers of health and social care.
At our follow-up inspection, we found the practice had made improvements across all five domains of safe, effective, caring, responsive and well led. Some improvement was still required in recruitment checks undertaken on locum GPs. Overall the practice is rated as Good
Our key findings across all the areas we inspected were as follows:
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The practice had made improvements that promoted the safe treatment of patients. We saw that arrangements were in place for an appointed GP to lead multi-disciplinary team meetings at the practice to manage the care of palliative patients. A named GP was appointed as the safeguarding lead for the practice.
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GPs delivering services were given sufficient time and support to familiarise themselves with systems in place at the practice, which resulted in the safer care and onward referral of patients to secondary care providers (hospitals and specialist clinics).
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Recruitment checks for staff were in place. However, all checks as required by Schedule 3 of the Health and Social Care Act (Regulated Activities) Regulations 2014 were not complete for locum GPs and several checks had not been carried out before the locum GPs started working for the provider.
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The practice had made improvements that increased the effectiveness of care for patients. The practice had a core group of locum GPs delivering services, which contributed to the effectiveness of treatment of patients by the practice and provided a degree of continuity of care.
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The Patient Participation Group (PPG) for the practice told us things had improved since the CQC inspection of 2014. Patients reported that they had seen improvements in the continuity of care and that GPs were caring and inclusive towards them.
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The provider had responded to the concerns of patients, communicating positively with the PPG.
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The provider leadership team had responded positively to the feedback from Inspectors following the inspection of November 2014. The retention of locum GPs to deliver services was more robust, and patients were familiar with these GPs. Strong clinical leadership was provided by a Clinical Director, appointed by the provider within the last 12 months.
There are areas where the provider MUST make improvements. The provider must:
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Ensure that all recruitment checks as required by Schedule 3 of the Health and Social Care Act 2008, are in place for all staff, including locum GPs.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice