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CQC places Nottingham GP practice into Special Measures

26 August 2016
The Willows Medical Centre
  • Media

England’s Chief Inspector of General Practice has placed The Willows Medical Centre, in Carlton, Nottingham, into special measures following a Care Quality Commission inspection which found the quality of care to be Inadequate overall.

Inspectors rated the practice as Inadequate for being safe, effective, responsive and well-led, and Requires Improvement for being caring following an inspection in June 2016. The inspection was carried out following serious concerns highlighted to the commission.

The Willows Medical Centre provides primary medical services to approximately 3,600 patients in Carlton, Gedling Village and Mapperley in Nottinghamshire.

A full report of the inspection, which details inspectors’ findings and highlights the areas where improvements must be made, has been published today.

Patients were at risk of harm because systems and processes were not in place to keep them safe. For example the practice was employing a healthcare assistant to undertake tasks outside of the responsibilities suitable for persons employed in such a role.

In addition there was no evidence to demonstrate they had the training and were competent to undertake a number of the tasks allocated to them. This member of staff was undertaking examinations, assessments and diagnoses of patients in spite of not being a registered or regulated healthcare professional in this country.

The report highlights a number of areas of concerns, including:

  • People did not feel confident about reporting incidents within the practice due to being reprimanded for doing this. Patient feedback indicated serious concerns were raised with the practice manager following a GP consultation but there was no evidence to show this had been recorded or investigated.
  • There were minimal arrangements in place to ensure staff were trained, supervised and supported in the roles and in the tasks they were expected to undertake.
  • Evidence from the clinical system showed that care and treatment was not being delivered in line with local and national guidelines.
  • Patients told us they found it difficult to book appointments in advance and a review of the appointment systems showed no appointments available to pre-book.
  • The practice did not have effective system in place to check the expiry dates of medical consumables. For example, inspectors found a large amount of out of date medical consumables including dressings, boric acid urine sample pots, histological specimen pots and over 100 blood collection tubes.

Janet Williamson, Deputy Chief Inspector of General Practice and Dentistry in CQC’s Central region said:

“It is important that the people who are registered with The Willows Medical Centre can rely on getting the high quality care which everyone is entitled to receive from their GP.

“We found a considerable amount of concerns following our inspection which led to us taking urgent enforcement action in the form of a temporary suspension to protect the safety welfare of patients who use the service.

“As well as the serious concern surrounding the unregistered staff member carrying out tasks they were not qualified for, there were not enough staff within the practice to ensure patients were kept safe.

“Staff confirmed they felt there were not enough staff and told us that requests for additional staff had been refused.

“The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements. The provider did not have arrangements in place to ensure safe, high quality care was provided to patients and had knowingly employed a healthcare assistant to undertake medical examinations which were outside the scope of the role and for which the individual was not registered or regulated.

“There was a culture of fear and blame within the practice and we were not assured that all significant events were reported and used as opportunities to

improve safety within the practice.

“CQC is continuing to work closely with Nottingham North and East Clinical Commissioning Group and NHS England to ensure all patients of the surgery have continued access to alternative GP services in the area.

“We will continue to monitor this practice closely alongside partner agencies to check whether sustainable improvements have been made.

“If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration if they do not improve.”


For further information, please contact Regional Engagement Officer, Helen Gildersleeve, on 0191 233 3379.

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Last updated:
29 May 2017

Notes to editors

CQC has published a full report about The Willows Medical Centre.

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 display of 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.