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GP surgery in NHS England director's super practice placed in special measures

A surgery in one of the country’s most established super practices has been rated 'inadequate' and placed in special measures by the CQC following an inspection.

All Saints Practice in Poplar, East London is one of 20 centres operated by the 100,000-patient Hurley Group, whose seven partners include NHS England director of primary care Dr Arvind Madan and former RCGP chair Dr Clare Gerada.

The inspection highlighted issues with child safeguarding record keeping, medicines storage and availability, learning from significant events, and a lack of evidence that staff were following policies around safety alerts.

It also says patients complained of a lack of continuity of care and difficulty booking urgent or routine appointments .

A spokesperson for the practice acknowledged it was struggling to recruit in a very deprived area but said the Hurley Group was ‘disappointed’ with the report’s findings and would be appealing them.

The inspection in November 2016 rated it inadequate in three of the five inspection domains: looking at whether services are safe, well-led, and caring.

A majority of the Hurley Group GPs are not partners and All Saints has one lead GP who works six clinical sessions a week, and a salaried GP who covers two.

The remaining 17 sessions are covered by locums from the Hurley’s own locum bank, and supported by nurses and healthcare assistants.

In a survey of patients ahead of the inspection and on the day patients reported that staff were professional and caring, but there was ‘general concern’ around seeing the same GP and appointment booking.

A spokesperson for the group told Pulse: ‘The Hurley was surprised and disappointed by the rating at the All Saints practice, and we have already submitted an appeal to this decision.’

They said the rating was inconsistent with the same processes and procedures in other Hurley practices rated ‘good’ but noted there were areas to improve.

They added: ‘Like most practices, we face recruitment challenges, and despite recent staff changes at the practice, we remain focused on providing continuity of care, which is especially important for this particularly deprived community.'

Dr Gerada told Pulse she has worked in All Saints previously and said it had 'an interesting patient population, but it is hard work and difficult to recruit permanent staff'.

She said she was ‘sorry to patients and staff’ if the practice had failed the CQC’s standards but added ‘our staff are trying their best in sometimes very difficult circumstances, and everybody, staff and patients should be shown care and compassion.’

The Hurley Group is one of the UK’s most well-known super practices, and is an earlier adopter of technology including its own online consulting and patient self-triage service.

Dr Madan resigned as chief executive when he took up the national director of primary care role in December 2015, though he is still a partner and works clinically one day a week and some weekends.

Last week NHS England that would financially incentivise practices to emulate the model by coming together in formal networks of between 30,000 and 50,000 patients.

Readers' comments (10)

  • Vinci Ho

    One way or the other , CQC (and perhaps NAO, national audit office) must present this reality to NHSE and DoH that forcing practices into a super conglomerate has a serious price to pay .
    Bottom line is starving of resources by the government whether the 'practice' is small, big or super .
    I think Simon carrying his 'grand plan' knows this very well but would not talk about that more openly..........

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  • X.Ray

    Not so super practice. I thought the whole point of these practices was to help buffer recruitment issues? Just shows that this system and system of central management is no better.

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  • SMALL PRACTICES ARE TREATED LIKE "TROUBLESOME TURDS" BY NHS ENGLAND....WHO ARE DESPERATELY TRYING TO FLUSH THEM AWAY AS SOON AS POSSIBLE.

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  • Healthy Cynic

    This clearly isn't a 'super-practice' is it. It is a collection of practices who share some back office functions. If it was one practice then surely the Hurley Group itself would need to be put in special measures.

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  • Why was he recuited to this post? What are his special credentials?

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  • This is about more than just a "failed" CQC inspection. General Practice salaried or partnership is simply unattractive for many doctors, hence the exodus to locum status. Make it attractive and they will join.

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  • Incentives are not going to be transparent. If NHSE wants to invest - there should not be a range - I like his face and colour so 50k and I don't like this chap so 30k or just a twiddle of the thumb.
    Why do we always have to have loopholes left for NHSE to exploit? Is this deliberate manipulation or just another show of how corrupt the NHS can get? Scrap NHSE and save billions which can then be reinvested into global sums to improve patient care.

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  • Seven partners, 20 practices, a hundred salaried doctors moving around wherever they are told in order to fill gaps (so no continuity of care and no real relationship with patients or community) - is that the kind of future Drs Madan and Gerarda want for our profession?

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  • It is hard work and difficult to recruit says Clare Gerada! So it evetwhere else Clare! Wake up to it. Yet others are not in special measure despite similar challenges.
    Dr Madan needs to return to practice full time rather than being an evangelist and preaching the masses.

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