A GP practice in East London has been taken over after it was found that patients were as risk of harm while some 'waited five years' for a diagnosis. Crawley Road Medical Centre in Leyton was found to be providing an 'inadequate' service that left some patients waiting years to receive their blood test results.
Although the practice received positive feedback after it was last visited by CQC inspectors in 2017, inspectors visiting the practice at the end of June rated it as performing poorly in every department. In one case, the practice, which is currently run by WF Federated GP Network, was reported to have taken five years to diagnose a patient.
Chief inspector Dr Sean O'Kelly said a backlog of work at the practice had led to delays in processing patients, in part caused by one GP partner also being a partner at another neighbouring practice. The inspector also said he couldn't verify the number of patients the practice was looking after, having seen various figures between 9,700 to 11,232.
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Dr O'Kelly wrote: "The approach to managing staff absences and busy periods placed patients at risk of harm. We were not assured that the GP partners spent sufficient time onsite to ensure there was adequate clinical oversight.
"In the past year, there were more than 200 outstanding documents that had not been filed. Most of the letters that required the GPs to issue prescriptions and place urgent referrals were not actioned and placed patients at imminent risk of harm.
"We found evidence that a patient received a five year delay in diagnosis where they were not informed of their blood tests and disease indication in 2017 by both GP partners who had been allocated this task.
"When this was investigated by the practice, they alluded to the GPs having difficulty with workload management which led to mental and decision fatigue as a cause for this error."
The inspectors also noted that the practice was not able to provide DBS certificates for all of its staff "despite repeated requests", nor were they able to provide proof that an asbestos problem found in the building last year had been resolved.
Dr O'Kelly said: "We found several errors in patient records such as incorrect alerts... and several spelling and grammatical errors that were illegible and made the notes difficult to decipher. We reviewed 71 patient records and found nearly all these patients had not been followed up following receipt of abnormal test results.
"We saw evidence where the inadequate management of test results by the practice led to patient harm. For example, one patient diagnosed with hypothyroidism last received appropriate blood tests in 2018 and their blood test levels were outside the recommended normal range."
In total, the practice had received 22 complaints, six of them after the inspection was done. One complaint came from a blind patient who said they'd been "treated in a rude manner by staff and turned away from the practice".
The inspector added: "Patients complained that some of the practice staff displayed a judgmental attitude towards them. Some patients complained that they were not allowed to contact the practice except through email only and they found this placed them at a disadvantage. Patients told us that they only received appointments based on who 'shouts the loudest rather than who needs the care the most'."
He continued: "Patients were also not given appropriate and timely information to cope emotionally with their care. This was due to patients being unable to access the service and the overdue monitoring for the 71 patient records we reviewed that placed patients at risk of harm."
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