Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Mill Road Surgery on 31 October 2016. The overall rating for the practice was good with a rating of requires improvement for providing effective services. We then carried out an announced focussed inspection on 17 October 2017 to confirm that the practice had made improvements on the recommendations that we identified in our previous inspection on 31 October 2016. This report covers our findings in relation to those recommendations.
The reports on the 31 October 2016 and 17 October 2017 inspections can be found by selecting the ‘all reports’ link for Mill Road Surgery on our website at www.cqc.org.uk.
Overall the practice remains rated as good.
Our key findings were as follows:
- The practice used the information collected for the Quality and Outcomes Framework (QOF) and performance against national screening programs to monitor outcomes for patients. The most recent published results showed that the practice had achieved 96% of the total number of points available, with 7% exception reporting. (QOF is a system intended to improve the quality of general practice and reward good practice. Exception reporting is the removal of patients from QOF calculations where, for example, the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate).
- Data showed the practice performed lower than local and national averages for bowel and breast cancer screening rates.
- Cervical screening rates were above local and national averages, as was exception reporting for this indicator.
- The practice’s performance on child immunisations had not improved; however, the practice maintained records on the patients that had not attended and shared information with the local health visiting team.
- There was a comprehensive monitoring system of patients taking high risk medicines at the practice. Patients received the appropriate monitoring required with high risk medicines. A database for blood tests and reviews was maintained by the practice manager who reviewed and discussed this with the GPs on a regular basis.
- The practice had reviewed the coding processes and services available for carers. The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 88 patients as carers (1.5% of the practice list). This was an increase from 18 patients at our inspection on 31 October 2016. Written information was available in the waiting room to direct carers to the various avenues of support available to them. One of the receptionists had been made a carers champion who provided additional training for the reception team and engaged with the local carer’s trust.
There was one area where the provider should make improvements:
- Explore further opportunities to support an increase in cancer screening rates and a decrease in exception reporting rates for cervical screening.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice