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CQC rates Sunderland GP Surgery as Inadequate

23 July 2015
Forge Medical Practice

England’s Chief Inspector of General Practice has rated a Sunderland GP Surgery as Inadequate and placed the practice into Special Measures following an inspection by the Care Quality Commission.

A specialist team of inspectors rated the service provided by The Old Forge Surgery as Inadequate for providing services that were safe, effective and well-led, requires improvement for responsiveness and good for caring. 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 practice was inspected in April 2015 by an inspection team which included a GP, a practice nurse and a specialist advisor with a practice management background. A full report of this inspection has been published on the CQC website today.

Although inspectors received some positive comments from patients during the inspection who said that they were treated with dignity and respect by staff, inspectors also identified a number of significant concerns.

Inspectors found a lack of effective systems in place to monitor the safe running of the practice. Systems were not robust, reviews of incidents were not always learnt from, and a limited number of clinical audits were being undertaken to improve patient outcomes.

The systems for monitoring patients’ medicines were ineffective and repeat prescriptions were not closely monitored. Some reviews were overdue and the practice was unable to demonstrate that patient’s repeat prescriptions were still appropriate and necessary.

The practice did not have an up to date infection control policy, infection control protocols were not comprehensive and had no detailed guidance for staff. Issues identified in a November 2014 infection control audit had not all been completed by the time of the inspection.

The practice had a management team but there was a lack of effective leadership. There were no clear priorities, vison or a development strategy for the leadership of the practice. Although the practice sought feedback from patients there was little evidence of shared learning with the relevant staff?.

Additional concerns were identified in relation to recruitment procedures at the practice as appropriate checks on staff had not been undertaken prior to their employment and necessary training was not fully completed.

The Care Quality Commission has identified a number of areas for improvement, including:

  • The practice must ensure that there are formal governance arrangements in place, including systems for assessing and monitoring the quality of the service provision.
  • The practice must have appropriate policies and guidance for staff to enable them to carry out their roles in a safe and effective manner.
  • The practice must ensure that audits of practice are undertaken, including completed clinical audit cycles.
  • The practice must take action to ensure that effective infection control systems are in place.
  • The practice must ensure relevant checks are carried out on staff, in relation to recruitment of new staff and the professional registrations of existing staff.
  • The practice must implement systems to ensure that patients’ medicines are effectively monitored and take action to ensure that blank prescription forms are handled safely.
  • The practice must provide appropriate training for all staff, including training on fire safety and information governance.

CQC is working closely with Sunderland Clinical Commissioning Group and NHS England to support the practice while it addresses the issues identified by the inspection.

Sue McMillan, Deputy Chief Inspector of General Practice said:

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

“Although patients we spoke with were positive about the care they received and said they were treated with compassion and dignity, our inspectors also found some significant concerns.

“Whilst we are aware that some of the registered GPs have recently been absent due to sick leave, which has had an effect on the leadership of the practice, the failure to implement effective systems to monitor the quality of the service and document learning from incidents are just some of the issues raised in the report. Immediate action must be taken in light of these findings so that people get safe, high-quality primary care.

“I do not believe that the practice is likely to resolve its challenges without external support. This is why we are placing the practice into special measures.

“After a period of six months we will inspect again to check whether sufficient improvements have been made. If we find that the service provided by this practice remains inadequate, we will consider taking steps to cancel its registration with CQC.”

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.


For further information please contact CQC Regional Communications Officer Mark Humphreys on 0191 233 3519.

For media enquiries about the Care Quality Commission, please call the press office on 020 7448 9401 during office hours. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here (please note: the duty press officer is unable to advise members of the public on health or social care matters). For general enquiries, please call 03000 61 61 61.

Last updated:
29 May 2017

Notes to editors

CQC has published a full report about The Old Forge Surgery.

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.