Archived: The Stansted Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Stansted Surgery on 14 April 2015. Overall the practice is rated as inadequate.

We found the practice was inadequate for providing safe and well led services.

We found the practice required improvement for providing, responsive, caring and effective services. It was also inadequate for providing services for the: older people; those with long term medical conditions; mothers, babies, children and young people; working age people and those recently retired; people in vulnerable circumstances who may have poor access to primary care; and people experiencing poor mental health. All of the population groups are also rated as inadequate as the concerns which led to our ratings across each of the domains also apply to each of the population groups.

Our key findings were as follows:

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example appropriate recruitment checks on staff had not been undertaken prior to their employment and actions identified to address concerns with infection control had not been taken.
• Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff following any investigations.
• Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
• Urgent appointments were usually available on the day they were requested. However patients said that they sometimes had to wait a long time for non-urgent appointments and that it was very difficult to get through to the practice when phoning to make an appointment.
• Some audits had been carried out. However, we saw no evidence that these audits were driving performance to improve patient outcomes.
• Complaints had been responded to but no learning from their cause or common themes was taking place.
• The practice did not have arrangements for identifying, recording and managing risk.
• The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements.
• The practice had not proactively sought feedback from staff or patients.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors to the premises.
• Seek and act on feedback from patients, for the purposes of continually evaluating and improving services.
• Ensure recruitment procedures are established and operated effectively to confirm that people employed are suitable for the role for which they are employed.
• Assess, monitor and improve the quality and safety of the service provided by putting in place processes for sharing and learning from significant events and complaints with all staff.
• The infection control lead must have appropriate knowledge and skills to undertake the role.
• Consultation room must be appropriately located to allow patients with mobility limitations to have access to timely appointments.

In addition the provider should:

• The practice should ensure that all staff are aware of and adhere to policies produced by the practice, for example the prescription security policy.

On the basis of the ratings given to this practice at this inspection, I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice