Shropshire GP surgeries facing new inspections

The Care Quality Commission (CQC) has introduced a new banding system to prioritise which surgeries should be inspected first using a plethora of information including patient experiences and surveys.

Eight out of the county's 66 practices - four in Telford, three in Shrewsbury and one in Ludlow - have been placed in the lowest "Band 1" rating, labelled "highest perceived concern" by CQC chiefs.

A further three, two in Telford and one in Shrewsbury, are in "Band 2".

Eleven GP surgeries in Shropshire have been rated in band one and band two, deemed to be of "highest perceived concern".

In Telford and the surrounding area they include:

• Wellington Medical Practice

• Hadley Health Centre

• Church Close Surgery in Madeley

• Shifnal Medical Practice

• Oakengates Medical Practice

• Ironbridge Medical Practice

In the Shrewsbury area they include:

• Riverside Medical Practice

• Mount Pleasant Medical Centre

• Westbury Medical Centre

• Belvidere Medical Practice

Also on the list:

• Ludlow’s Portcullis Surgery is also in the lowest two bands

The CQC said surgeries in bands one and two would be considered for inspection from next year, so the watchdog could quickly "determine the quality and safety of care within them".

In Telford and the surrounding areas, concerns have been raised about Wellington Medical Practice, Hadley Health Centre, Church Close Surgery in Madeley, Shifnal Medical Practice, Oakengates Medical Practice and Ironbridge Medical Practice.

In Shrewsbury, Riverside Medical Practice, Mount Pleasant Medical Centre, Westbury Medical Centre and Belvidere Medical Practice have been earmarked for inspection, while Ludlow's Portcullis Surgery was also put into the worst two bands.

But it was not all bad news - exactly half (33) of Shropshire's GP surgeries were placed into "Band 6", deemed the category of "lowest perceived concern" by the CQC.

The Commission said it would be using specialist inspection teams including GPs or practice nurses and trained members of the public as part of the new approach.

Nationally, the figures have revealed almost eight out of 10 GP surgeries in England appear to be of low concern.

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Professor Steve Field, chief inspector of general practice for the CQC, said: "There is a lot of good and outstanding care taking place across the country.

"While it is positive that 78 per cent of general practices are currently a low concern based on the available data, there is no reason for complacency and standards must continue to improve.

"It is important to remember that the data is not a judgement, as it is only when we inspect we can determine if a practice provides safe, high-quality and compassionate care.

"The data is a further tool that will help us to decide where to inspect and when."

The CQC has been tasked with inspecting and rating every general practice in England over the next two years.

In the same way Ofsted does for schools, surgeries will be rated as outstanding, good, requires improvement or inadequate. Bosses hope it will help people make informed choices about their care and encourage improvement in quality.

Patients today defended the care they receive at GP surgeries in Shropshire – while a county health watchdog said she hoped the new inspection regime would lead to improvements to make it easier for people to book appointments.

The Care Quality Commission (CQC) has been given two years to inspect every general practice in the country in a new Ofsted-style schools system.

It has divided the surgeries into six categories using information such as the results from patient surveys to determine which general practices should be inspected first.

Eleven GP surgeries in Shropshire have been rated in band one and band two, deemed to be of "highest perceived concern".

They include Wellington Medical Practice, Hadley Health Centre, Church Close Surgery in Madeley, Shifnal Medical Practice, Oakengates Medical Practice and Ironbridge Medical Practice in Telford and the surrounding area.

In Shrewsbury, Riverside Medical Practice, Mount Pleasant Medical Centre, Westbury Medical Centre and Belvidere Medical Practice have been earmarked for inspection, while Ludlow's Portcullis Surgery was also put into the lowest two bands.

Kate Ballinger, manager of patient watchdog Healthwatch, said getting appointments was the most common problem reported to them.

She added: "We are currently working with other local Healthwatches, including Shropshire, on a GP Access project and are visiting some of the surgeries listed to gather patient experience around appointment booking.

"We would very much like to hear how local people feel about their experiences of all GP practices in Telford & Wrekin and would encourage people to get in touch with us."

But patients at the surgeries named have been quick to jump to their defence.

Mike Powell, 67, from Belvidere in Shrewsbury, who uses Riverside Medical Practice, said: "I have never really had any problems and have been coming here for years.

"Like today I have been for my flu jab – I missed my appointment on Saturday and rearranged yesterday for today and I have been in and out.

"The staff and service is always fine and I have never really encountered any problems; that said, I only come here maybe once or twice a year."

Katrina Baker, 51, from Waters Upton, uses the medical centre at Wellington.

She said the doctors and nurses were "excellent" but added: "It is the booking systems that cause us concern.

"It's frustrating, you have to speak to a doctor and wait for them to ring back. There is always a delay."

Derek Sheldon, 77, of Broadway, Ketley, said of the Wellington GP surgery: "Getting appointments is quite good. You can get in to see a doctor. Sometimes they can be a bit abrupt and sometimes there seems to be a lack of care, it depends who you get."

Joanna Ofmanska, 35, from Wellington, uses Hadley Health Centre and said: "All the ladies are nice who work here and I've never had a problem with appointments."

John Jarvis, 78, from Harlescott, who uses Riverside, said: "This is a great doctors surgery.

"I have had them out for call-outs twice over the last couple of months because I have had to and they have been great.

"And when I come here they are also good.

"I have been coming here all my life and the only thing you sometimes get is it can be a bit hard to get through over the phones to make an appointment, but apart from that I think it's a fine GP."

Averill Collins, 67, from Harlescott, who also uses the Riverside, said: "I have been coming here since I was 16 and this practice has always been fine.

"The staff are nice and the service is generally very good.

"The only problem you sometimes get is trying to get an appointment. They like to call you back and take details on the phone when sometimes you want to see someone face-to-face. But that's the only problem I have ever had here."

Tracy Willocks, practice manager at Riverside, said: "

We had a fully compliant routine Care Quality Commission visit in October 2013 and we are welcoming them again this week for another visit using the new inspection regime.

"We acknowledge that our building imposes restrictions to the services we can offer to our patients and we are working to resolve this.

"The practice are delighted that we have recently appointed a new doctor and nurse to augment our team."

None of the other 10 GP practices highlighted wished to comment.

Elevated risks at county practices:

A range of information was gathered at every surgery in the country for 38 different indicators to determine "elevated risks" in making a final assessment to see which band the practice would go in.

Every practice has been placed into bandings from one (highest perceived concern) to six (lowest perceived concern) to help plan inspections from next year.

The Care Quality Commission (CQC) has been at pains to stress the bandings are not judgements, which will only be made following the inspections next year. They will be reassessed every three months.

At Wellington Medical Practice, those collating the evidence identified four "elevated risks", three of which related to the results of the annual GP survey carried out at the surgery. The CQC was concerned about the low numbers who said they were able to get an appointment when they wanted one, or were always able to see their preferred doctor.

Concerns were also expressed at the number of over-65s who had received a flu vaccination at the surgery.

The results of the patient survey also uncovered risks at Shifnal Medical Centre, particularly the low numbers who said the doctor or nurse they saw was "good at involving them in decisions about their care".

At Ludlow Portcullis, the low percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan was classed as an "elevated risk". This was also classed as the sole elevated risk for Riverside and Belvidere GP surgeries in Shrewsbury and Hadley Health Centre in Telford, while concerns were also expressed at the number of women at the Hadley practice who had had a smear test in the last five years.

Risks at Church Close Surgery in Madeley, Telford, and Ironbridge Medical Practice centred around patients with diabetes, while at Westbury near Shrewsbury concerns were raised about the number of antibiotic items prescribed.

At Oakengates, a risk was identified based on the number of people who answered "fairly good" or "very good" when asked about the "overall experience" of their GP surgery, while difficulty getting through to the surgery on the phone was also highlighted.

The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of alcohol consumption in the preceding 12 months was picked out as a risk at Mount Pleasant in Shrewsbury.

A spokesman for CQC said: "When CQC identifies a 'risk' or 'elevated risk', it does not necessarily mean that people using the practice are at risk, but where patients may be at risk. Our inspections will determine whether GP practices are providing safe and effective care."

CQC is the independent regulator of health and social care in England. It monitors, inspects and regulates services to ensure they meet quality and safety standards.