CQC places Priory Avenue GP Practice into Special Measures

England’s Chief Inspector of General Practice has placed a Reading GP practice into special measures following an inspection by the Care Quality Commission.

A specialist team of inspectors has rated the service provided by Priory Avenue Surgery in Caversham as Inadequate for being safe, effective and well-led, and Requires Improvement to be caring and responsive. The practice has been given an overall rating of Inadequate.

Before the inspection North and West Reading Clinical Commissioning Group had notified CQC of significant concerns around the leadership of the practice which might affect the care of patients. Since then the CCG and NHS England have been working closely with the provider and the Care Quality Commission to ensure that services to patients are safe and effective.

The Priory Avenue surgery was inspected in November by a CQC team which included a specialist inspector, two GP advisors, a practice manager and a practice nurse. A full report of this inspection has been published today. 

At the time of the inspection the practice had been going through significant staffing changes, with a series of resignations causing disruption for several months.

Although patients said they could usually get an urgent appointment, some reported considerable difficulty in accessing a named GP, or seeing the same doctor on subsequent appointments.

Inspectors found that there had not always been enough clinical staff to support the practice population, especially if a GP was off sick, when many appointments had to be rescheduled or cancelled.

Patient records were not up to date with recent test results or discharge information from hospital, suggesting that people may not have been receiving appropriate follow up treatment or care.

The Care Quality Commission has identified 14 areas for improvement, including:

• The practice must take immediate action to address current staffing issues to ensure safe minimum levels are reached.
• Clinical leadership and management must be provided for all staff.
• The practice must develop and implement a system to regularly identify risks and improve quality in relation to patient safety.
• All patients’ records must be updated with appropriate information and documents in relation to the care and treatment they have received.
• Regular infection control audits must be undertaken, and a cleaning schedule introduced for practice equipment.

Ruth Rankine, Deputy Chief Inspector of General Practice said:

“It is clear that the Priory Avenue surgery has been going through a period of upheaval - with so many staff leaving that the practice simply hasn't been able to cope. There had been constant failures in communication between the current directors and GPs, leaving the practice staff demoralised and disillusioned.

“What matters most is the effect on patients. The basic process of sharing information about patient care had been severely compromised - with a backlog of letters from hospital, or reports from out of hours services which needed to be processed and acted on.

“Patients told us there had been a significant change of GPs in the last two months. One person told us they saw a different GP each time they had come in the last month. At times people have had to wait up to four weeks for a routine appointment with their preferred doctor.

“Patients should be able to expect high quality and consistent care from their GP practice. It is important that the 8,000 people who are registered with the Priory Avenue surgery can rely on getting the high quality care which everyone is entitled to receive.

“We have found significant areas of concern, which is why we are placing the practice into special measures - so opening the way to a package of support from NHS England among others.

“We will continue to monitor this practice and we will inspect again in six months to check whether sufficient improvements have been made. I am hopeful that the practice will do what is required for the sake of its patients, but if we find that the service remains inadequate, we will consider taking steps to cancel its registration.”

Patients registered with the practices being 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. These practices will not close.

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

“We’d like to reassure patients that their safety is our top priority, there is no evidence of direct clinical risk to patients or of patients being harmed. We urge the 8,000 patients registered at Priory Avenue Surgery to continue to support the GP practice.

“We have already begun work with the practice to ensure action plans are in place. Many of the leadership and organisation issues are already being remedied. The backlog with patient letters has been resolved and patients are able to get same day GP appointments when needed. With the additional support from the Royal College of General Practitioners and our continued joint working with the local CCG this should help to improve performance quickly.”

Ends

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