Archived: Dr Leach and Partners

Updated 12 March 2018

Market Quarter Medical Practice is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 7,500 patients living in the town centre and surrounding areas of Rugby. A GMS contract is a standard nationally agreed contract used for general medical services providers.

The practice operates from a modern purpose built, two storey building with disabled access and parking. The reception area is spacious and allows easy access for patients using mobility aids. The building is shared with another GP practice and accommodates other community services such as Improving Access to Psychological Therapies (IAPT), Social Prescribing, a psychologist and Abdominal Aortic Aneurysm (AAA) screening and retinal screening.

The practice population has a higher than average number of patients aged 15-64 years. National data indicates that the area is one that does not experience overall high levels of deprivation, although there are pockets of deprivation where patients experience high unemployment, drug and alcohol problems. The practice population is predominantly made up of white British patients with some Eastern European and Asian ethnic minority groups.

There are two GP partners, one male and one female and one salaried female GP. The practice employs a nurse consultant who is male, a practice nurse, a health care assistant and practice manager who are supported by a team of administration and reception staff. It is a training practice and at the time of our inspection there were three trainee GPs.

The practice offers a range of services including, minor surgery, long term condition monitoring, cervical cytology and child health services.

The practice is open on Monday to Friday from 8am until 6.30pm. The practice offered their own extended hours appointments on one Saturday each month from 9am until 12pm for their own patients. The premises was also used as the Rugby hub for the Coventry and Rugby Alliance extended hours service which gives all patients in the area access to primary care services from GPs and nurses six days a week until 9.30pm and every Saturday morning. There is also an option to be seen in a Coventry hub on Sunday mornings. When the practice is closed services are provided by the local out of hours provider by Care UK accessed via the NHS 111 service.

Updated 12 March 2018

Letter from the Chief Inspector of General Practice

This practice is rated as requires improvement overall. The practice has not been inspected previously.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Requires improvement

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 – Requires improvement

People with long-term conditions – Requires improvement

Families, children and young people – Requires improvement

Working age people (including those recently retired and students – Requires improvement

People whose circumstances may make them vulnerable – Requires improvement

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

This is because the areas of safe and responsive require improvement which affect all population groups.

We carried out an announced comprehensive inspection at Market Quarter Medical Practice on 10 January 2018 as part of our inspection programme.

At this inspection we found:

• The practice demonstrated that they had managed risk so that safety incidents were less likely to happen. We saw that when incidents did happen, the practice discussed these at clinical meetings and learned from them and improved their processes as a result. We noted that significant events had been investigated and learning had taken place.
• The practice had appropriate recruitment procedure in place. However, we noted that some records did not contain all the information required to demonstrate this had been followed and whilst the practice assured us that this had been obtained they were unable to provide evidence of this.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. We saw evidence that care and treatment was delivered according to evidence-based guidelines.
• Patients reported that staff involved them in decisions about their care and that they were treated with compassion, kindness, dignity and respect. The patient participation group reported that the practice engaged well and responded to suggestions made by the group.
• The practice operated a triage list for patients who needed a consultation on the same day. This was in addition to on the day and pre-bookable appointments.
• There was a strong focus on continuous learning and improvement at all levels and a commitment to teaching and staff development. The practice was a teaching practice and had up to four GP registrars at any one time whom they supported.

The areas where the provider must make improvements are:

• Ensure specified information is available regarding each person employed.

The areas where the provider should make improvements are:

• Ensure complaints are a standard agenda item at meetings to ensure shared learning.
• Routinely offer health checks to all carers.
• Record any actions taken when a child on the risk register does not attend a hospital appointment.
• Continue to monitor the uptake of cervical screening.
• Continue to improve telephone and appointment access and monitor patient satisfaction regarding these areas.

Professor Steve Field CBE FRCP FF PH FRCGP

Chief Inspector of General Practice