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Review carried out on 10 June 2021

During a monthly review of our data

We carried out a review of the data available to us about Market Square Surgery on 10 June 2021. 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 Market Square Surgery, you can give feedback on this service.

Inspection carried out on 23 November 2020

During a routine inspection

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

Inspection carried out on 07/10/2019

During an inspection looking at part of the service

We carried out an inspection of Market Square Surgery on 7th October 2019 due to the length of time since the last inspection. We previously inspected this practice on 24th October 2014. 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 requires improvement overall and requires improvement for all population groups.

We have rated this practice as Inadequate for providing safe services because:

  • Prescribing was not always in line with guidance.
  • Action was not taken following patient safety alerts.
  • Patients prescribed medicines that required monitoring, including high-risk medicines, were not being reviewed.
  • Prescription stationery was not being tracked as it was distributed to clinicians around the practice.

We have rated this practice as requires improvement for providing effective services. Families, children and young people and working age people (including those recently retired and students) is rated as requires improvement for providing effective care because:

  • The practice did not have suitable arrangements to identify and review the treatment of women of childbearing age on long-term medicines that may be of risk.
  • Targets in relation to cervical screening had not been met. There were insufficient arrangements to monitor and improve performance.

We have rated this practice as requires improvement for providing well-led services because:

  • Systems to identify, manage and mitigate risks were not effective.

The areas where the provider should make improvements are:

  • Continue to review and improve Public Health data relating to cervical screening.

The areas where the provider must make improvements are:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Details 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

Inspection carried out on 24 October 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

On 24 October 2014 we carried out an announced comprehensive inspection of Market Square Surgery, Waltham Abbey, Essex under our new approach of inspection of primary medical services.

We found that the practice was good across all the key areas we looked at and patients expressed a high level of satisfaction about the way the services were provided.

Our key findings were as follows:

  • The practice had systems and processes in place that made the practice safe for both patients and staff.
  • Staff were kind and caring and dedicated to providing high quality care and treatment. Patients privacy and dignity was maintained.
  • The practice were aware of the needs of their patients and tailored services to meet them
  • The practice worked well with other health care providers to achieve effective outcomes for their patients. Information sharing and communication with partner agencies helped support the levels of care and treatment received by patients.

However, there were also areas of practice where the provider should make improvements.

The provider should:

  • The practice should undertake a Health and Safety Risk Assessment to ensure staff and patients are safe.

  • The practice should ensure staff are suitably trained in fire emergency procedures and that fire drills are practised at appropriate intervals.

  • The practice should review their repeat prescription system to ensure patients receive a regular review of their medicines.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice