Prospect Surgery

Updated 14 April 2022

Prospect Surgery is located at:

The Health Centre,

20 Cleveland Square,

Cleveland Health Centre,

Middlesbrough,

TS1 2NX

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures. These are delivered from a single site.

The practice is situated within the Tees Valley Clinical Commissioning Group (CCG) and delivers General Medical Services to a patient population of about 6,400. This is part of a contract held with NHS England. The practice is part of a wider network of GP practices (Central Middlesbrough Primary Care Network that delivers services to approximately 48,000 patients in central Middlesbrough).

Information published by Public Health England shows that deprivation within the practice population group is in the lowest decile (one of 10). The lower the decile, the more deprived the practice population is relative to others. According to the latest available data, the ethnic make-up of the practice area is 13% Asian, 81% White, 2% Black, 2% Mixed, and 2% Other.

There is a team of four GPs, two are partners and two are salaried GPs (three are male and one is female). The practice has a team of two nurses and one health care assistant. The nurses provide nurse led clinics for childhood immunisations and are currently undergoing required training to enable them to provide clinics for patients with long-term conditions and for cervical smears. The GPs are supported at the practice by a team of reception and administration staff and a practice manager.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needed to see a patient face-to-face then the patient is offered a face to face appointment.

Extended access is provided locally by STAR – the local extended GP hours service accessed via telephoning NHS 111, where late evening and weekend appointments are available. Out of hours services are provided by telephoning NHS 111 or NHS 999 for a life-threatening medical emergency.

Updated 14 April 2022

We carried out an announced inspection at Prospect Surgery on 24 March 2022. Overall, the practice is rated as Good.

The ratings for each key question are:

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 9 July 2021, the practice was rated Inadequate overall and for all key questions, except for Caring and Responsive which were rated as good. The practice was placed into special measures at that time. At our July 2021 inspection serious concerns were identified with regard to the safe care and treatment of patients, and the overarching governance of the practice. There was a lack of monitoring, risk assessments, record keeping and governance arrangements supporting the delivery of safe care and treatment. We were not assured that the service was safe. The practice was rated as inadequate overall. At this March 2022 inspection, we saw evidence of improvements in all of these areas previously identified.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Prospect Surgery on our website at www.cqc.org.uk.

Why we carried out this inspection

This inspection was a comprehensive follow-up inspection to follow up on the previous rating of inadequate. We looked at:

• All five key questions
• Breaches of regulations and ‘shoulds’ identified in previous inspection

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• 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 have rated this practice as Good overall.

We found that:

• The practice had improved the way it provided care to keep patients safe and protected them from avoidable harm.
• Improvements made to monitoring of high risk medicines and actions on safety alerts meant that patients received effective care and treatment that met their needs.
• Staff treated patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed had significantly improved from our previous inspection. The provider had begun to promote the delivery of high-quality, person-centred care.

We found no breaches of regulations.

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

• Take steps to improve the way that carers are identified and coded, to maximise their access to health improvement opportunities.
• The provider should continue to work to improve cervical cancer screening rates for eligible women, in line with national targets.
• Improve the recording of DNACPR information by ensuring that all forms are completed fully.

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care