Background to this inspection
Updated
5 January 2021
Market Square Surgery is located in Waltham Abbey, Essex and provides GP services to approximately 13,300 patients who live in Waltham Abbey and the surrounding towns and villages. It is commissioned by West Essex Clinical Commissioning Group (CCG).
Waltham Abbey has higher levels of deprivation, being on the fifth more deprived decile. The Index of Multiple Deprivation ranks every small area in England from 1 (most deprived area) to 32,844 (least deprived area). Life expectancy of men and women is approximately two years below the CCG average. 58.2% of patients have a long-term health condition, compared to the CCG average of 48.9%.
The practice is governed by three GPs, two male and one female. The practice is a training practice and therefore supports qualified doctors to complete the necessary training to become a GP, although there are no registrars currently employed.
Since our previous inspection, the practice has become the lead for the primary care network (PCN).
Updated
5 January 2021
We carried out an inspection of Market Square Surgery on 23 November 2020. This inspection was to follow up on breaches of regulations identified at a previous inspection on 7 October 2019 and to provide new ratings for the practice.
At our previous inspection, we found concerns with monitoring prescription stationery, prescribing high-risk medicines, action following patient safety alerts and performance for cervical screening. The practice was rated as requires improvement overall, with inadequate for safe and requires improvement for effective and well-led. Caring and responsive were rated as good.
We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering how we carried out this inspection. We therefore undertook some of the inspection processes remotely and spent less time on site. We conducted staff interviews between 12 November 2020 and 19 November 2020 and carried out a site visit on 23 November 2020.
Following our review of the information available to us, including information provided by the practice, we focused our inspection on the following key questions:
- Are services at this location safe?
- Are services at this location effective?
- Are services at this location well-led?
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. All population groups were rated as good, except people whose circumstances make them vulnerable, which was rated as outstanding. This was because:
- The practice had overstaffed during the lockdown period to ensure that services continued to be responsive. The practice used these resources to review and monitor vulnerable patients.
- The practice had reviewed and improved processes for responding to the needs of patients in care homes and shared these at PCN level.
- Innovative systems were implemented to ensure that the needs of this group were met during lockdown.
The areas where the provider should make improvements are:
- Review and improve feedback in the GP patient survey around the care provided.
- Continue to review and improve Public Health data relating to cervical screening.
Details of 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