CQC raps Lakeside surgery after patients struggle to make appointments

Lakeside Healthcare’s Cottingham Road, Forest Gate and Brigstock surgeries have been given a ‘requires improvement’ rating by the government overseer the Care Quality Commission following an inspection that also found safety to be inadequate.

One of the major issues included problems with people getting through to the surgery to book appointments. The inspectors said patients had reported ‘dissatisfaction’ with access to appointments and to the practice by telephone.

Although the practice had an action plan to address the issues, at the time of our inspection there had not been time to embed the new processes.

In a survey, only 39 per cent of patients had recorded a positive response to the experience of trying to book an appointment, compared to a UK average of 69 per cent.

The number of patients who were happy with their appointment time was 34 per cent and the percentage of patients that were happy with the type of appointment they were given was 54 per cent, compared to a national average of 74 per cent.

The CQC report stated: “The practice were fully aware of patient dissatisfaction with access.

“Following the 2018 GP Survey and 2017 CCG survey which both highlighted issues in getting through to the practice, the practice produced an action plan to address the issues. They had held staff meetings, focus groups and workshops in order to identify the strengths and weaknesses of the current system.

“A reception team manager had been appointed who restructured the reception team, improved the 33 induction and training programme for receptionists and set standards and KPI’s for the team. There were

ongoing plans to further restructure staff working patterns and redesign the call handling model in order to deal with the peaks and troughs of incoming calls. The practice had added a further four incoming

telephone lines in July 2018.”

“The practice had audited capacity and demand and as a result were carrying out ongoing recruitment in order to provide more clinical sessions. They had employed a community nurse practitioner whose role included home visiting with a view to reducing the number of home visits carried out by GPs. An additional advanced nurse practitioner had also been recruited to provide more appointments.”

The surgery was also criticised because inspectors said that prescribers of high risk medicines were not always in possession of accurate and reliable information about patients that enabled them to make safe, considered judgements.

The surgery was praised for its safeguarding processes and infection control.

Inspectors, who carried out their visit in November, also found several issues with prescription and medicine management. Their report said: “The provider did not act in accordance with national guidelines in respect of prescription security.

“We found that some rooms which contained prescriptions in the printers were not kept locked.

“We found medicines at the Forest Gate Surgery which had exceeded the manufacturers’ use by date, despite checks of the medicines having been recorded as having been carried out. The checking process for expiry did not involve physically checking the medicines themselves, only checking the attached stock sheet which did not reflect the contents of the bag.

“Atropine prefilled injection and Prednisolone 5mg contained in the emergency medicines bag had expired in February and August 2018 respectively and there were no rectal diazepam tubes available.

“There was no Benzyl penicillin available at Forest Gate Surgery to treat patients presenting with severe infections.

“Clinicians in the surgery were unable to locate this medicine for use in the surgery and there was no risk assessment for not holding this emergency treatment.”

In the area of effective needs assessment, care and treatment the organisation was rated ‘good.’

The report said: “The practice followed up on older patients discharged from hospital. It ensured that their care plans and prescriptions were updated to reflect any extra or changed needs.

“Staff had appropriate knowledge of treating older people including their psychological, mental and communication needs.

“Health checks were offered to patients over 75 years of age.

“The practice aimed to provide as much care as locally as possible for patients. A number of GPs had specialist interests and provided specialist clinics for patients who would otherwise have had to travel to community or secondary care providers.

“Services available at the practice and to which patients could be referred included physiotherapy and a local wellbeing clinic.”

A Lakeside Healthcare spokesman told the Northants Telegraph: “We thank the CQC for their detailed and helpful report. It highlights those areas where we have made good progress and helps us identify other areas where improvements are needed.

“We have been rated ‘good’ in the Caring and Effective domain, whilst our Safeguarding Service for our most vulnerable patients, is noted as ‘outstanding’.

“Due to the known and widely published pressures on GPs right across the country, we accept that in recent months we were not always able to provide the very high level of service that we would want for our patients or is expected.

“Following the initial feedback from CQC, we took immediate actions to improve the care and experience for all our patients. We will continue to work closely with the Corby Clinical Commissioning Group to deliver any required improvements. It is important to note that Lakeside is committed to providing the best possible care for our patients and the right culture and working environment for our staff.

“The Corby clinical leadership team are focused fully on our Quality Improvement Plan and we will continue to talk openly and honestly with our patients about the progress we are making and any challenges we might face.

“We understand that local people want to see further progress made, particularly in relation to access to our various services. We will continue to listen to their views and experiences to improve matters.

“Our priority is always to provide safe, caring and compassionate care for our patients.”