The Care Quality Commission
  • Doctor
  • GP practice

The River Surgery

Overall: Good read more about inspection ratings

16 Rous Road, Buckhurst Hill, Essex, IG9 6BN (020) 8504 7364

Provided and run by:
The River Surgery

All Inspections

During an assessment under our new approach

Date of Assessment: 19 to 26 March 2026. The River Surgery is a GP practice and delivers service to almost 5000 people under a GMS contract held with NHS England.

The National General Practice Profiles state that 78.03% of people registered are White, 11.91% are Asian, 2.98% are Black, 4.39% are Mixed and 2.69% are Other.

Information published by the Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 9 decile (9 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.

19 July 2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at The River Surgery on 19th July 2016 to check that improvements had been made.

At our previous inspection of 19th October 2015, the practice was rated as requires improvement overall, with requires improvement for safe, effective and well-led. It was rated as good for providing caring and responsive services. As a result of our inspection of 19th October 2015, the practice was issued with a requirement notice for improvement.

Necessary improvements have been made, and the practice is now rated as good.

Our key findings across all the areas we inspected were as follows:

  • The repeat prescribing policy had been updated to reflect current systems and practices.

  • Infection control training had been provided to all staff.

  • There had been a recent infection control audit.

  • Staff were aware of lead roles at the practice, and who to go to if they had safeguarding concerns.

  • Pre-employment checks were robust and sought to ensure that newly recruited staff were suitable for their roles.

  • There were systems to ensure that patients taking high risk medicines were regularly monitored.

  • Significant events were consistently recorded and routinely discussed.

  • The emergency medicines kit was routinely checked and all medicines in this were in date.

  • All staff received an appraisal.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

19 October 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The River Surgery on 19 October 2015. Overall the practice is rated as requires improvement. Specifically, we found the practice to be requires improvement for providing safe, effective and well-led services. It was also requires improvement for providing services for older people, people with long term conditions, families, children and young people, working aged people (including those recently retired and students), people whose circumstances make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings across all the areas we inspected were as follows:

  • Data showed patient outcomes were good for the locality. Audits had been carried out and we found that these were used to drive improvement in performance to improve patient outcomes.
  • 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.
  • Urgent appointments were available on the day they were requested.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, when things went wrong the system to report and record significant events was inconsistent. There was no structured system to periodically review significant events in order to identify themes and learning.
  • Evidence of conduct in previous employment was not always satisfactory when staff were recruited.
  • The arrangements for managing medicines, including emergency drugs in the practice did not always keep patients safe. The repeat prescribing policy was last reviewed in 2013, and this did not reflect the practice’s current arrangements in relation to high risk medicines. We were told that that medicines were monitored through medicine reviews with patients and the repeat prescribing process, however, we found a number of patients who were taking prescribed medicines that required regular monitoring had not had their bloods tested within the required time frame.
  • None of the staff working at the practice, including the clinical lead, had received training in infection control. An infection control audit had been undertaken in 2013 and we saw evidence that some action had been taken to address improvements identified as a result, however, many actions remained outstanding.
  • Not all staff had received an annual appraisal.
  • The practice had a number of policies and procedures to govern activity, but not all staff were aware of their content or who had responsibility.
  • The practice had proactively sought feedback from patients.

The areas where the provider must make improvements are:

  • Take all appropriate steps to ensure staff are fit for the role for which they are employed.
  • Ensure that patients who are prescribed medications that require monitoring are identified and relevant patients are called for blood tests.

In addition the provider should:

  • Progress actions against the infection control audit of 2013 including the provision of infection control training for all relevant staff, including the clinical lead;
  • Ensure all staff have received an annual appraisal;
  • Update the repeat prescribing policy;
  • Ensure that when emergency drugs are routinely checked that all identified actions are taken;
  • Record significant events consistently;
  • Ensure staff have read relevant policies and procedures and are aware of lead roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

3 December 2013

During a routine inspection

We found the service to be welcoming with friendly staff. Practice information was displayed for people who used the service, including health promotion, access to support and other available services. Appointments could be made in person at the surgery or by telephone.

We spoke with seven people who all spoke highly of the services provided to them. We also spoke with staff who said they enjoyed working in the practice.

People's needs were assessed and care and treatment was planned and delivered in line with their individual wishes. One person said, "I've been coming here for a long time and have never had any complaints." Another person said, 'The doctors and nurses are very good at listening properly and not fobbing people off.'

We saw that there was a system to ensure repeat prescriptions were available promptly and medicines that were kept at the practice were stored safely.

Staff were supported through appraisal, supervision and regular staff meetings.

The practice had a complaints policy in place. Any dissatisfaction from people who had used the service was treated promptly and appropriately. There were systems in place to ensure that staff members learnt from any complaints in an effort to prevent future occurrences.

We found that space at the premises was restricted and presented some challenges to both staff and patients. However, the provider had made some adaptations to enable people with mobility problems to have equal access.