Old Catton Medical Practice

We carried out an announced comprehensive inspection at Old Catton Medical Practice on 29 January 2018. The overall rating for the practice was good, with a requires improvement rating for providing safe services. We issued a requirement notice against regulation 17 of the Health and Social Care Act Regulations 2014 Good governance, as the practice did not have effective systems for managing safety alerts and pathology results in a timely way.

We also identified areas the practice could improve and should:

• Review the use of information technology systems to drive improvement, including coding suspected cancer referrals and the templates used to record care and treatment for palliative care patients.
• Provide timely annual reviews for patients with learning difficulties.
• Monitor and review patient survey results and respond accordingly.

The full comprehensive report on the January 2018 inspection can be found by selecting the ‘all reports’ link for Old Catton Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 15 November 2018 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 29 January 2018.

This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

Overall the practice is now rated as good, with a good rating for providing safe services.

At this inspection we found:

• Systems and processes were reviewed and improved to effectively manage safety alerts and pathology results.
• The system for coding suspected cancer referrals was reviewed and improved and the recording template for palliative care templates was effective in record all necessary information.
• The practice reviewed their list of patients with learning difficulties and increased the numbers of structured annual reviews completed. We also saw that patients who had not yet had an annual review were scheduled to have one.
• The practice had also reviewed the latest GP patient survey data and were taking action to improve the results, including commissioning a telephone system audit, increasing GP staffing levels, increasing telephone answering capability during busy periods.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

This practice is rated as Good overall. (Previous inspection September 2015 – Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Old Catton Medical Practice on 29 January 2018.

At this inspection we found:

• The practice had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the practice learned from them and improved their processes. The practice shared outcomes of significant events with staff and other local GP practices where appropriate.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff were consistent and proactive in helping patients to live healthier lives.
• The facilities and premises were appropriate for the services delivered.
• The practice learned from external safety events as well as patient and medicine safety alerts but two recent safety alerts regarding the prescribing of gabapentin and quinine had not been received by the practice. When we raised this with the practice they undertook responsive action immediately.
• Annual health assessments for people with a learning disability were undertaken; however the practice had 35 patients on the learning disabilities register, of which only five had received a health review in 2017. After the inspection the practice informed us that 12 of these patients had been seen in the period October to December 2016.
• The practice used information technology systems to monitor and improve the quality of care but we found improvement was needed to optimise its use. For example, the practice did not make use of a recording template for palliative care patients and processes for reviewing pathology (blood test) results could not assure us that all results had been reviewed timely.
• Results from the July 2017 annual National GP Patient survey showed that patients’ satisfaction with the practice was generally below local and national averages.
• The practice had a clear vision and credible strategy to deliver high quality care and promote good outcomes for patients.

The area where the provider must make improvements as they are in breach of regulations is:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Review processes for, and the use of, the information technology systems to drive and monitor good quality care.
• Review the processes for the coding of two week wait cancer referrals.
• Ensure patients with a learning difficulty receive timely annual reviews.
• Review the recording template for palliative care patients.
• Continue to review patient survey results and respond to these results accordingly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice