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CQC inspectors place GP practice in Shrivenham into special measures

17 December 2015
  • Media

England’s Chief Inspector of General Practice has placed the Elm Tree GP practice at Shrivenham in Wiltshire into special measures following an inspection by the Care Quality Commission.

A specialist team of inspectors rated the service as Inadequate for being safe and well-led, although it was rated Good for being effective and caring, and Outstanding for being responsive. The practice has been given an overall rating of Inadequate.

Under CQC’s new programme of inspections led by Professor Steve Field, Chief Inspector of General Practice, all of England’s GP practices are being inspected and given a rating.

The Elm Tree Surgery was inspected in October 2015 by an inspection team led by a CQC lead inspector accompanied by a GP, a practice nurse advisor and an expert by experience. A full report of this inspection has been published on this website.

Inspectors found that the practice was well equipped to treat patients and meet their needs. The practice worked closely with other organisations and with the local community in planning how services were provided.

But the practice did not operate a consistent approach to managing safety and risk:

  • Although staff understood and fulfilled their responsibilities to raise concerns and to report incidents, the learning from such events was not always communicated. Staff reported that when they raised concerns they were not always responded to.
  • Systems to keep medicine safe were not operated effectively and action had not been taken in response to an audit of infection control processes.
  • There was insufficient attention to safeguarding children and vulnerable adults. Staff were not clear on how to report safeguarding concerns outside the practice and details of safeguarding authorities had not been updated.

Ruth Rankine, Deputy Chief Inspector of General Practice, said:

“In many respects the Elm Tree Surgery provides an effective service to its patients. But it is important that everyone who is registered with the surgery can rely on getting the safe, high quality care which they are entitled to receive from their GP.

“The practice did not demonstrate a culture of managing safety and assessing risk and we found poor levels of collaboration and cooperation between some members of the team.

“In particular we found Elm Tree Surgery Inadequate for safety and Inadequate for being well led which is why we are placing the practice into special measures, so that it can get the support that it needs.

“After a period of six months we will inspect again to check whether sufficient improvements have been made. If we find that the practice remains inadequate, we will consider taking further action.”

Dr Geoff Payne, Medical Director at NHS England, said:

“We’d like to reassure patients that their safety is our top priority. Following the CQC rating we will ensure that Elm Tree Surgery receives additional support to help make improvements in the running of the practice. More effective management and improvements in risk assessments, infection control measures and medicines management will help to raise performance.

“It is clear that the staff at Elm Tree Surgery are caring and compassionate: the practice is rated outstanding for being responsive to people’s needs and good for being caring and effective. The CQC found that many patients commented on the excellent service they receive from Elm Tree Surgery. We urge patients to continue to support the practice as we work closely with them and Swindon Clinical Commissioning Group to ensure an action plan is swiftly developed and implemented.”

Dr Peter Crouch, Clinical Chair of Swindon Clinical Commissioning Group said:

“General practice is the bedrock of the NHS and Elm Tree Surgery has demonstrated many areas where it excels in patient care such as the availability of GP appointments.  It is widely recognised that all GPs and their staff are having to deal with increasing demand, rising expectations and increasing complexity in their patient workload. Swindon CCG together with NHS England fully supports Elm Tree Surgery to address any necessary improvements as set out by the CQC in order to continue delivering safe, high quality care to all its patients.”


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Last updated:
29 May 2017

Notes to editors

CQC has published a full report about Elm Tree GP practice.

Patients registered with practices which are placed into special measures should be aware that the package of support being offered by NHS England and the Royal College of GPs will ensure that there are no immediate risks to patient safety at these GP practices whilst improvements are being made. This does not mean that these practices will close.

To get to the heart of people’s experiences of care, we always ask the following five questions of services.

  • Are they safe?
  • Are they effective?
  • Are they caring?
  • Are they responsive to people’s needs?
  • Are they well-led?

For every NHS GP practice we will look at the quality of care for the following six population groups: Older people, People with long-term conditions, Families, children and young people, Working age people (including those recently retired and students),People whose circumstances may make them vulnerable, People experiencing poor mental health (including people with dementia).

Since 1 April, providers have been required to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily. Further information on the requirement for providers to prominently display their CQC ratings.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.