- GP practice
Archived: The Bush Doctors
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All Inspections
7 December 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Bush Doctors on 9 October 2014. The overall rating for the practice was requires improvement. The full comprehensive report on the 9 October 2014 inspection can be found by selecting the ‘all reports’ link for The Bush Doctors on our website at www.cqc.org.uk.
This inspection was an announced comprehensive inspection carried out on 7 December 2016 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 9 October 2014. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
Overall the practice is now rated as good.
Our key findings across all the areas we inspected were as follows:
- There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
- Risks to patients were assessed and well managed.
- The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
- Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
- Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients said they were able to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
- The provider was aware of and complied with the requirements of the duty of candour.
The areas where the provider should make improvement are:
- Monitor performance of the Quality and Outcome Framework (QOF) indicator relating to the cervical screening programme to ensure improved patient engagement and outcomes are in line with local and national averages.
- Continue to review patient feedback on the late running of appointments in order to ensure continuous improvement.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
9 October 2014
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced, comprehensive inspection of The Bush Doctors on 9 October 2015. The practice is located in Shepherds Bush in West London and provides care to 11,850 patients.
We rated the practice as Requires Improvement overall for the quality of its services. The practice was rated as Good for being caring and as Good for being responsive to the needs of its patients. However improvements were required to ensure the practice was providing fully safe and effective care and was well-led.
Our key findings were as follows:
- Staff understood their responsibilities to raise concerns, and to report incidents and near misses. Risks to patients who used services were assessed and the practice had systems to address risks in relation to infection control, medicines management and emergency situations.
- The practice had developed the service and skills of the staff team to meet patients’ needs. We found that care for long term conditions such as mental health was managed effectively and was provided in partnership with other specialist services.
- Patient survey results were in line with local and national averages for the quality of care and consultations. The practice scored better than other practices locally for the extent to which patients felt involved in decisions about their care. Patients we spoke with were very positive about the quality of care they received.
- The practice reviewed the needs of its local population and engaged with the clinical commissioning group (CCG) to secure improvements to services where these were identified.
However there were also areas for improvement. Importantly, the practice must:
- Carry out and document all necessary recruitment checks including checking proof of identity of new members of staff
- Ensure that all staff members receive an annual appraisal and support to develop in their role. The practice must also ensure that clinical team members have opportunities for formal supervision.
- The practice must ensure that the risk to patients has been properly assessed in relation to managing poor staff performance.
- The practice must ensure that informed consent is documented before undertaking minor surgical procedures.
In addition the provider should:
- Consider further action to address late running of appointments. This had occurred fairly regularly at the practice and affected patients’ experience of the service.
- Provide clear information for patients about the length of any likely delays to appointments.
- The practice should have systems in place to ensure that the clinical team are aware of safety alerts and are acting on these as required.
- The practice should ensure that all staff are reporting incidents consistently and in line with practice policy.
- The practice did not keep records to show that staff had satisfactorily completed their induction.
- The practice contingency plan should be tailored to reflect the specific risks affecting this practice.
- The practice should ensure that audit recommendations are implemented effectively.
- The practice should consider ways to encourage patients age 40-74 to attend for a health check.
- Review opportunities for the wider staff team to meet to reflect on learning and good practice.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice