• Doctor
  • GP practice

Bay Medical Group

Overall: Requires improvement read more about inspection ratings

Morecambe Health Centre, Hanover Street, Morecambe, Lancashire, LA4 5LY (01524) 511999

Provided and run by:
Bay Medical Group

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Bay Medical Group on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Bay Medical Group, you can give feedback on this service.

10 October 2023

During a routine inspection

We carried out an announced comprehensive inspection at Bay Medical Group on 10 October 2023. Overall, the practice is rated as requires improvement.

Safe - requires improvement

Effective- requires improvement

Caring - good

Responsive - requires improvement

Well-led - requires improvement

We rated the practice as requires improvement for safe, effective, responsive and well-led care because:

  • Systems and processes to ensure care was safe were not always operating effectively, the provider had not always identified all risks and could not always demonstrate how they ensured that all required remedial actions had been taken in a timely way.
  • Care and treatment for patients with long-term conditions did not always reflect national guidance and childhood vaccination update remained below national averages despite the range of work the provider was undertaking to improve this.
  • People were not able to easily get through to the practice by telephone or access appointments in a timely way and the practice complaints process was not fully effective.
  • Governance processes were not consistently effective; staffing pressures were impacting on staff wellbeing and the provider had failed to submit statutory notifications to CQC.

During the inspection process, the practice highlighted efforts they were making to improve outcomes and treatment for their population. Some of these were in development so there was not yet verified evidence or data to show effectiveness of these efforts.

Following our previous inspections in 2015, the practice which later became Bay Medical Group were rated good overall with safe, effective, caring, responsive and well-led key questions rated good. Coastal Medical Practice was rated outstanding for providing responsive services because:

  • The practice was using a tele-health system to monitor their patients with long-term conditions and taking part in an initiative offering patient’s access to a GP from 8am to 8pm as part of a ‘Prime Ministers Funding Initiative’.

At this inspection, we found that those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. The practice continued to develop innovative ways to respond to the needs of the local population. However, 25% of phone calls to the practice had been abandoned in the previous 12 months. The national GP patient survey showed that only 31% of patients responded positively when asked how easy it was to get through to the practice by telephone and the complaints system was not fully effective.

The practice is therefore now rated requires improvement for providing responsive services.

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

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities including the age of the last rating.

We inspected and rated all 5 key questions: safe, effective, caring, responsive and well-led.

How we carried out the inspection

We carried out some aspects of this inspection remotely by video conferencing and visited all 5 practice sites on 10 October 2023.

Our remote activity included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Reviewing a large range of evidence and documentation from the provider.
  • A site visit where we spent time in all 5 branch locations and spoke with GPs, senior leaders, managers, administrative staff and medicines management staff including pharmacists.
  • Reviewing surveys completed by Bay Medical Group staff about their work.
  • Speaking with 4 members of the Bay Medical Patient Voice Group.
  • Reviewing information which patients have shared with CQC.
  • Gathering information from partners including Lancashire and South Cumbria Integrated Care Board (ICB).
  • Reviewing nationally available data on the practice performance.

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 found that:

  • The practice team fully understood the complexities of their practice population and worked innovatively with statutory and voluntary partners to reduce health inequalities in the local area.
  • The provider’s systems were not always effective and did not always identify or mitigate all risks to staff and patients. These included premises safety, infection prevention and control, recruitment, incidents, accidents and complaints.
  • The practice was not able to answer incoming calls from patients in a timely way, particularly the most critical time each morning. However, access to urgent appointments and triage was available throughout the day and monitored by leaders.
  • Most patients received effective care and treatment that met their needs, though our searches identified some areas of long-term condition where the provider was not following national guidance.
  • Patient records were not always up to date and complete.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The provider had developed positive development culture with staff empowered to suggest and trial improvement activity to improve patient outcomes.
  • The provider had not reported 4 incidents as notifications to CQC in line with statutory requirements.

There were examples of outstanding practice:

The focus on engaging with partners and community groups to reduce health inequalities and promotion of primary care health through social media was demonstrating incremental improvement for people whose circumstances made them vulnerable. This included:

  • Improving engagement with people with learning disabilities and encouraging them to attend the practice. The practice had achieved 95% in the reporting year between 1 April 2022 – 31 March 2023 for providing health checks for patients on the practice learning disability register.
  • Working effectively with community groups and external partners to promote cancer screening and increasing uptake of bowel, breast and cervical screening.
  • The implementation of enhanced health checks for specific neighbourhoods to address health inequalities which was helping raise awareness, understanding and uptake of national screening, vaccination programmes and health checks.

We found 3 breaches of regulations. The provider must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure that any such action as is necessary and proportionate is taken when any member of staff is no longer fit to carry out their duties.
  • Comply with the Care Quality Commission (Registration) Regulations 2009 on statutory notification of incidents.

In addition, the provider should:

  • Take action to improve management of incoming telephone calls and reduce abandoned calls.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care


During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Coastal Medical Group on 04/11/2015. Overall the practice is rated as good.

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. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • 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.
  • Patients said they sometimes found it difficult to make an appointment in advance with a named GP but there was continuity of care, with urgent and some non-urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice was currently taking part in an initiative offering patient’s access to a GP from 8am untll 8pm as part of a Prime Ministers Funding Initiative.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

We saw some areas of outstanding practice:

  • The use of ‘Florence’ a simple tele-health service to advise and assist patients to manage their own conditions with arm’s length support from professional should a change in their condition be detected.
  • The practice had self-funded the employment of two advance nurse practitioners and one trainee advanced nurse practitioner as part of a continuity of care programme. This had allowed patients to have greater access to support in the practice, and had meant that GP’s had more free slots to see patients who required their specific assistance with their needs.
  • The practice had received national recognition for their work with the Gold Standard Framework (care for patients at the end of their lives) and Palliative Care.
  • The practice had a cohesive and effective medicines management team who worked alongside the GP’s for maximum optimisation of patient’s medication and they had managed to save £240,000 in last year through more effective medicine management.
  • The practice had successfully gained approval to offer third year student nurse placements at the practice and were now supporting other practices to achieve this status.
  • The medicine management team monitored patients who were prescribed an increasing dose of medication and contacted them to ensure they were managing their increases in a timely manner.

One area where the provider should make improvement is:

  • Developing an annual audit plan for the practice, this will allow the practice to plan their activity demonstrating a review of care and processes from a strategic level rather than adhoc audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

23 October 2013

During a routine inspection

We spoke individually with the registered manager, senior managers and staff at Coastal Medical Group. We also discussed care with three patients and two relatives. We reviewed staff records, policies and procedures and various audit records.

The service ensured that whilst people were receiving treatment, they were cared for in a supportive and respectful manner. One person told us, "I'm very happy with my practice". Additionally, people expressed feeling in control of their treatment and felt decisions were made jointly.

The service had effective safeguarding practices in place. Staff had a good understanding of related principals. Training and supervision were provided and staff we spoke with told us they felt highly supported.

Coastal Medical Group had a variety of appropriate processes in place to monitor the quality of service provision. The practice had effective systems to manage complaints appropriately.