Archived: Cordley Street Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cordley Street Surgery on 29 April 2016. Great Bridge Partnerships for Health, Sai Surgery was also visited as part of the same inspection as both locations share the same patient list, although Cordley Street is a branch surgery. This report therefore reflects the service delivered from both locations.

Overall the practice is rated as requires improvement.

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 a programme of clinical audits.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• The majority of patients said they were treated with compassion, dignity and respect.
• The practice had not taken action to address the areas of low satisfaction from the national patient survey.
• Information about services and how to complain was available and easy to understand. Improvements were made as a result of complaints and concerns.
• Patients said it was difficult to make an appointment with a named GP, which affected continuity of care, however urgent appointments were available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff felt supported by management. The practice had an active patient participation group (PPG) and acted on feedback provided from the PPG.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are:

• The provider must have effective systems to enable them to assess and monitor the quality of the service by; actively seeking and act on views of people who use the service, about their experience and quality of the care and treatment delivered in order to improve the quality of the service.

• The provider must ensure care and treatment provided to patients is appropriate, meets their needs and reflects their preferences by ensuring care plans are sufficiently detailed and updated following changes in their circumstances actively seek and act on views of people who use the service, about their experience and quality of the care and treatment delivered.

The areas where the provider should make improvements are:

• The provider should take more proactive steps to promote bowel and breast screening in the practice.

• The provider should investigate the reasons for high exception reporting in mental health indicators and take more proactive steps to ensure patients are recalled and monitored

• The provider should put systems in place to monitor improvement following the installation of additional telephone lines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice