St Andrews Medical Centre

We carried out an announced comprehensive inspection at St Andrews Medical Centre from 21-23 June 2023. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive – Requires improvement

Well-led - Good

We have not previously inspected the practice since it became a partnership. Prior to that the service was provided by one of the current partners as an individual provider and was inspected on 7 December 2020 when it was rated requires improvement overall. It was rated requires improvement for providing safe, effective, caring, responsive and well-led services. We carried out a follow-up visit on 21 October 2022 to check that the practice had addressed breaches of regulations. We did not rate the practice at that time.

During the inspection process, the practice highlighted efforts it was making to improve access to the service in response to increased patient demand after the COVID-19 pandemic. These had only recently been implemented so there was not yet verified evidence to show the impact, for example, in the national GP patient survey results.

Why we carried out this inspection

The practice partnership was newly registered in April 2023. This inspection was the first inspection following the change in registration. At this inspection, we covered all key questions:

• Are services safe?
• Are services effective?
• Are services caring?
• Are services responsive?
• Are services well-led?

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:

• 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 short site visit.

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 found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs. However, the practice was underperforming on the cervical cancer screening target.
• Staff were able to provide examples of how they treated patients with kindness and respect. The practice had improved its scores in relation to patient experience.
• Patients could access care and treatment in a timely way, prioritising patients with more urgent needs. However, patient feedback about access was variable. The practice had adjusted its appointment system in response to patient feedback.
• The way the practice was led promoted the delivery of high-quality, person-centre care.

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

• Continue to monitor patient experience of access and make adjustments as required.
• Follow-up patients with asthma in line with guidelines if they have received 2 or more courses of rescue steroids in the previous 12 months.
• Take action to improve its performance in relation to cervical screening and childhood immunisation targets.
• Make arrangements to inform staff about a freedom to speak up guardian.
• Take action to expand the patient participation group.

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