The Care Quality Commission (CQC) regulates all health and social care provisions in England and routinely carries out inspections to check whether standards are being met at healthcare services across the country.
When inspections take place, the CQC inspectors will rank services into one of four categories:
- Outstanding
- Good
- Requires Improvement
- Inadequate
CQC report into GP service providers in Leicestershire
Recent CQC reports show that, overall, services in Leicestershire fit mainly into ‘Outstanding’ or ‘Good’, but there are unfortunately some that are falling below the required standards.
There are six GP service providers in Leicestershire which are rated as ‘Requires Improvement’ by the CQC. And, unfortunately, there are also some GP services in Leicestershire which have fallen into the lowest category of ‘Inadequate’:
- East Park Medical Centre – R P Pandya Medical Centre at East Park Road, Leicester, and at Doncaster Road, Leicester;
- Ar-Razi Medical Centre (Dr Abdul-Kader Vania) at 1 Evington Lane, Leicester;
- Privategp.com Ltd on Knighton Grange Road, Leicester.
East Park Medical Centre
This GP practice was inspected again in March 2022 and the CQC report became available in June 2022. Overall, the practice is rated as inadequate. This is because the CQC found:
1. The practice did not have clear systems and processes to keep patients safe.
2. The Practice did not appropriately maintain its safeguarding registers, the safeguarding policy was not comprehensive and staff had not completed training relevant to their role.
3. Review of staff files showed gaps in recruitment practice and vaccination records were not in line with the current guidance when relevant to the roles undertaken.
4. The practice had ineffective systems in place to ensure risks were mitigated in relation to the premises.
5. The practice had ineffective systems and processes in place to manage and monitor infection control and cleanliness.
6. On reviewing the staff training, the CQC inspectors found some of the clinical and administrative teams had not completed the practice’s required training in line with their roles.
7. The provider did not have appropriate systems in place for the safe management, supply, storage, checking, and prescription of medicines. Emergency medicines were not readily available.
8. On reviewing a sample of patients’ records, CQC inspectors found systems and processes to manage the effective delivery of safe patient care were not robust. Patient reviews, assessments, medication reviews, management of high-risk medications, unplanned admissions to hospital, patients with long-term conditions, and clinical coding were not always completed appropriately.
9. The provider was unable to show that the staff had the skills, knowledge, competence, and experience to carry out their roles. The inspectors found no evidence that staff had received regular review appraisals or audits of clinical practice.
10. The leaders at the practice did not have full oversight of the challenges and risks to quality and patient care within the service.
11. The practice was unable to provide evidence to show plans were in place to develop leadership capacity and skills, including planning for the future leadership of the practice.
12. Inspectors found governance structures and systems were not robust to support safe and effective care. For example, processes to manage risks, staff training, patient health, and medicines reviews were not effective.
13. The practice had not developed a system to ensure service users had access to up-to-date information, the practice website did not contain current information.
14. The provider was unable to demonstrate that clinical audit had a positive impact on the quality of care and outcomes for patients. There was limited evidence of audits undertaken with no evidence of action provided to change practice to improve quality.
Inspectors also found breaches of regulations.
The CQC has therefore put this GP service into special measures, meaning that it will be inspected again within 6 months. When inspected again, If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, the CQC can then consider taking action within their enforcement procedures to begin the process of preventing the service provider from operating the service at all.
The GP service will be kept under review and could be escalated to urgent enforcement action.
You can read more about the CQC findings and the full report on this GP service here.
Ar-Razi Medical Centre (Dr Abdul-Kader Vania)
This GP service comprises a single-handed male GP, supported by four locum GPs. Unfortunately, this is not the first poor report for this service.
The practice was inspected by the CQC in January 2020 and was rated overall as requiring improvement, with an inadequate rating for providing effective services.
This led to a further inspection being undertaken in April 2021 to see if improvements had been made.
This practice was rated as inadequate at the inspection in April 2021 and was placed in special measures. Following the inspection, the practice was issued with four warning notices in relation to breaches of regulation 12 (safe care and treatment); regulation 13 (safeguarding service users from abuse and improper treatment); regulation 17 (good governance); and regulation 18 (staffing).
An inspection was undertaken in July 2021 to review compliance with the warning notices that were issued and had to be met by the end of June 2021. At that time, it was found that the practice was mostly compliant with the warning notices, but further work was required in some areas, therefore further requirement notices were issued. The inspection was not rated and therefore the ratings remained unchanged.
The CQC carried out an unannounced inspection on 8 February 2022. Overall, the practice remains rated as inadequate.
- Safe – inadequate
- Effective – inadequate
- Caring – requires improvement
- Responsive – inadequate
- Well-led – inadequate
The inspection on 8 February 2022 took place to review the practice’s special measures status, and also in response to a number of whistle-blowing allegations received by the CQC.
You can read more about the findings in relation to this service on the CQC website.
Privategp.com Ltd
This GP service provides an alternative means for patients to receive medical consultation, examination, diagnosis, and treatment by general practitioners and medical and clinical specialists. It is an independent provider.
The service is registered to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services, treatment of disease, disorder, or injury, and services in slimming clinics.
The service is available to any person and does not require a clinical referral. Whilst most patients will be from the Leicester area, the service sees people from other parts of the country.
The service is delivered by two GPs, one of whom is the medical director and the Chief Executive Officer, assisted by a practice nurse.
Again, this is not the first time this service has had issues.
The CQC carried out an announced inspection on 17 November 2021 to review compliance with three warning notices issued following their previous inspection on 12 October 2021. In addition, the CQC returned to the practice on 1 December 2021 to review patient records as part of the same inspection.
In October 2021, the service was rated as inadequate overall and also for the key questions of safe, effective, and well-led. The practice was placed into special measures.
The inspection on 17 November 2021 was undertaken to review compliance with the warning notices which had to be met by 16 November 2021, but this inspection was not rated. The ratings from October 2021 therefore still apply and will be reviewed via a further inspection to take place within the next six months. The service remains in special measures.
You can read more about the findings of this service here.
Comment
The CQC inspections are invaluable in ensuring patient safety is upheld to the highest standards. The public should be aware to check the CQC ratings of any healthcare providers they intend to access, as this will give a good overview of the standard of the particular service.
It is worth focusing on the bigger picture here that, overall, services in Leicestershire fit mainly into ‘Outstanding’ or ‘Good’ categories. This, despite the ever-present pressures faced by healthcare providers, is great to see.
However, the CQC report has highlighted the need for the public to be aware of particular GP services in Leicestershire which are failing to meet the standards required.
Some of these healthcare providers falling into the lowest possible rating are repeat offenders, and clearly not learning lessons. Patient safety has to be at the forefront here, ensuring that those not meeting the standards are held accountable and, if necessary, restricted in their registration to practice. Maintaining these standards is vital.
How can we help?
Danielle Young is a Legal Director in our Medical Negligence team, which has been ranked in tier one by the independently researched publication, The Legal 500.
If you have any questions in relation to the subjects discussed in this article, then please get in touch with Danielle or another member of the team in Derby, Leicester, or Nottingham on 0800 024 1976 or via our online form.
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