Town surgery battles back from the brink

Three of the Sleaford Medical Group Partners Dr Gaspar Da Silva, Dr Vindi Bhandal and Dr Elton Pardoe. EMN-181218-103104001
Three of the Sleaford Medical Group Partners Dr Gaspar Da Silva, Dr Vindi Bhandal and Dr Elton Pardoe. EMN-181218-103104001

The town’s largest GP surgery is bouncing back from being placed in ‘special measures’ by Care Quality Commission inspectors 20 months ago to now being rated ‘Good’.

The inspection team had rated Sleaford Medical Group as ‘Inadequate’ in April 2017, and a follow up visit a year later failed to find enough improvement, meaning the practice was faced with the threat of losing its registration.

But, since then the GP partners have spent many extra hours putting in the necessary paperwork and procedures to show they have the necessary evidence that things are working better.

Partner Dr Elton Pardoe added: “Only about three per cent of practices manage to get out of special measures, they often get closed down and taken over by another provider.”

But, there had been the real doubt about what would happen to the 18,000 patients on the books.

Senior partner Dr Vindi Bhandal commented: “We were in a very difficult position because of workforce and resources being tight and we were caught out by a change in the inspection regime - nothing had really changed. We had commitments to changes in the organisation of health care in the area with a five year plan and two of our partner GPs were taken away to help at a strategic level.”

Inspectors became increasingly forensic in their requirements leading to spiralling workloads.

One of the important tasks was training more staff up to handle logging patient data into the computers that can be used to flag up illness trends. Regular meetings between departments, with new leaders, made sure the 60 staff are all better informed.

Dr Pardoe said: “The partners have had to show significant leadership and put in lots of extra hours to comply with the CQC enforcement action that they placed upon us. We didn’t want to let patient care suffer so we ended up coming in on days off and weekends.”

This meant they hired in locum cover which has had a significant financial impact which could not have been survived without help and the support of the CCG.

Now a far greater number of minor ailments and checks can be handled by a practice nurse or healthcare professional, under oversight of a duty GP.

A specialist unit from the Royal College of Medical Practitioners did a review of the surgery’s systems, bringing in a new way of dealing with long term condition reviews by nurses, only needing a GP if things changed.

The practice also introduced a clinical computer template which throws up a step by step system of reminders for trainees, locums and other health care staff to care for common conditions.

They also completely redesigned the website to make it more interactive for patients to self-diagnose whether they should see a GP, nurse, pharmacist or A&E, freeing up phones and appointment slots for those less tech-savvy.

The partners say they are relieved to have a ‘Good’ result. Dr Bhandal said: “We do not mind being inspected. We should be safe and providing quality treatment. Our staff underwent a lot of stress. They felt they were letting the practice down. We have put them through a lot of changes.”

Dr Pardoe said: “We must never rest on our laurels again. We are trying to set up self help groups in the practice for such things as bereavement and our Patient Participation Group is quite active now.”