Cardinal Medical Practice: Three years on, have over 30,000 Ipswich patients been let down?

In September 2021, a wave of patient dissatisfaction with Cardinal Medical Practice in Ipswich came to light through a letter from Dr Dan Poulter, the then-MP for Central Suffolk and North Ipswich, addressed to the Care Quality Commission (CQC).

Concerns over accessibility, appointment scheduling, and the overall patient experience prompted a thorough investigation into the practice's performance.

Since then, patients have voiced their opinions through various channels, including the Healthwatch Suffolk website and the GP Patient Survey conducted by Ipsos on behalf of NHS England.

The survey, published in July 2024, illuminates key aspects of the practice, such as ease of contact, appointment experiences, and the level of support provided for long-term conditions.

While there are some signs of improvement in specific areas, the practice still lags behind local and national averages in several critical areas.

It is currently our town’s worst-performing practice.

Our investigation evaluated whether Cardinal Medical Practice has progressed since the initial concerns were raised and whether or not a risk is posed to the primary care of more than 30,000 Ipswich residents.

This article provides an in-depth look into Cardinal Medical Practice's ongoing journey through a detailed analysis of survey results, patient feedback, and official responses.

Most importantly, it has forced the issue with the CQC and newly-elected MP Jack Abbott to act.

January, 2021

Cardinal Medical Practice was formed in July 2021 by merging 3 surgeries

At that time, it had around 30,000 registered patients, making it the largest single GP practice in Ipswich.

Immediately after the merger, concerns were raised in the local press about patient access, and a Facebook group was set up to highlight all the problems that had arisen at the surgery post-merger.

September, 2021

Dan Poulter raises concerns with health bosses

Patient complaints came to a head in September 2021 when Dr Dan Poulter, then MP for Central Suffolk and North Ipswich, raised concerns about Cardinal Medical Practice in a letter to the Care Quality Commission (CQC).

Dr Poulter's letter outlined three primary issues:

1. Excessive phone wait times, often exceeding an hour

2. Significant delays for virtual or phone consultations following initial triage

3. Limited access to timely face-to-face appointments

He wrote: "As a practicing NHS doctor myself, I am sympathetic to the challenges that have been faced by all parts of the healthcare system, including general practice, during the Covid-19 pandemic. That said, the number of complaints I have received about Cardinal Medical Practice is very concerning."

A spokesman for the CQC said: "We were aware of issues at this practice through our engagement with patients, the provider of the service and the local clinical commissioning group.

The information Dr Poulter raises is further informing our monitoring of the service.”

"We are also meeting the practice's leaders in the coming weeks to discuss the service's performance."

NHS confirms new “super-surgery” to open in 2024

In the same month, the NHS confirmed that a new 'super-surgery' should open in 2024 after health bosses had given it the go-ahead in 2017.

The new centre was proposed to replace the Deben Road and Chesterfield Drive practices with a ‘super surgery’ featuring 29 clinics, 11 nursing rooms, a centre for minor operations, and a pharmacy. The Norwich Road surgery would be retained for administrative uses.

Speaking to the EADT at the time, Dan Poulter said: "It is disappointing that it has taken so long to get to this position but I am pleased we finally seem to be getting there. I have spoken to the CCG recently and I was encouraged by what they said.”

"Hopefully the surgery will be able to offer services that are currently only available at the hospital which would be very good for local people."

Concerns about bus routes were raised as potential stumbling blocks.

October, 2021

Health bosses respond

Following Dr Poulter's letter, the Ipswich and East Suffolk Clinical Commissioning Group (CCG) met in October 2021 to discuss the practice's performance.

David Brown, deputy chief operating officer of the CCG, reported some improvements: "We are definitely starting to see an improved position. The waits have reduced dramatically. Another thing that has reduced dramatically is the number of people who called and then abandoned their call."

To our knowledge, no evidence was provided to back up claims of improved service.

In the same month, over 1,500 people participated in a ten-week consultation about plans to build the new Cardinal Medical Practice ‘super-surgery.’

The centre was originally set to open its doors in 2024, but the forecast is revised to 2025.

May, 2022

A contradictory CQC inspection

In May 2022, seven months after they met to discuss Cardinal Medical Practice’s performance, the Care Quality Commission (CQC) inspected the practice.

The inspection report, published on 26 May 2022, rated the practice as "Requires Improvement" overall.

Contradicting previous assurances from David Brown of the CQC, the practice was rated as follows:

• Safe: Requires Improvement

• Effective: Requires Improvement

• Caring: Good

• Responsive: Requires Improvement

• Well-Led: Requires Improvement

The report highlighted several areas of concern, including inadequate systems for managing blank prescriptions, issues with the storage of emergency medicines, and incomplete processes for reviewing clinical letters.

July, 2023

New provider takes over Cardinal Medical Practice, but patients continue to raise concerns

Despite a new provider, patient reviews on Healthwatch Suffolk suggested that significant issues persisted, broadly in line with the findings of the CQC inspection in May 2022.

Patient complaints on Healthwatch Suffolk

To our knowledge, no updates on the proposed ‘super-surgery’ have been published.

July, 2024

GP Patient Survey results are published, highlighting familiar shortcomings

Three years after Cardinal Medical Practice was formed and an incredible two years and two months after the damning CQC inspection in May 2022, the GP Patient Survey, published in July 2024, reveals that Cardinal Medical Practice continues to underperform in several key areas compared to national averages.

In fact, it is currently the worst-performing practice in Ipswich by a considerable margin.

Accessibility:

• Phone contact: Only 15% of patients find it easy to contact the practice by phone, well below the national average of 50%

• Website contact: 39% find it easy, compared 48% nationally

• NHS App contact: 38% find it easy, compared to 45% nationally

Appointment availability:

• Seeing preferred healthcare professional: Only 25% usually get to see their preferred professional, versus 40% nationally

• Satisfaction with appointment times: 56% are satisfied, compared to 66% nationally

Patient satisfaction:

• Overall experience: 53% rate their experience as good, well below the national average of 67%, which many would consider too low

• Confidence in healthcare professionals: 86% express confidence and trust, compared to 92% nationally

• Reception staff helpfulness: 75% find staff helpful, compared to 83% nationally

One area where the practice performs slightly above average is in support for long-term conditions, with 69% of patients feeling supported by local services compared to 68% nationally.

Cardinal Medical Practice has improved online accessibility, administrative support, and holistic patient care. However, significant challenges remain regarding phone accessibility, appointment scheduling, and patient satisfaction.

No updates – until now

Evidence suggests that little progress has been made in three years and that intervention is required to address the challenges the practice seemingly continues to face.

However, there has been little in the way of updates.

Since the merger three years ago, the Suffolk and North East Essex (SNEE) ICB, which oversees all primary care aspects in our area, has provided minimal feedback regarding Cardinal Medical Practice.

The CQC has also provided little update since its inspection in 2022, so we reached out to understand why.

The CQC's view and commitment to re-inspect the practice

A spokesperson for the CQC provided the following update to Ipswich.co.uk:

"Since CQC rated Cardinal Medical Practice in Ipswich as requires improvement in 2022, a new provider took over in July 2023. They are aware of the issues we found under the previous provider, and we have been monitoring them closely to ensure people are safe whilst they make the necessary improvements.

“CQC plans to re-inspect Cardinal Medical Practice based on our ongoing priorities for inspection, that focuses on visiting services where people are most at risk.

“CQC’s priority, at all times, is the health and wellbeing of people using health and social care services, and all information we receive informs our monitoring of services and future inspections. If we’re not satisfied people are receiving safe care we will not hesitate to take action in line with our regulatory powers.

“We would encourage anyone who has concerns about a health and social care service to let us know. This can be done by using the give feedback on care form on our website or via our customer service centre on 03000 616161.”

Jack Abbott's view

When approached for comment by Ipswich.co.uk, Jack Abbott, MP for Ipswich, assured us that he was “very aware of the ongoing concerns about the quality of care at Cardinal Medical Practice" before, inevitably, pointing the finger at the previous Conservative government and sharing his views on how our new Labour government plans to address the issues:

“This is not a reflection on the hard-working staff at the Practice, but rather an indication of the wider state of our NHS after 14 years of Conservative negligence.

“Labour has a plan for our NHS - from ending the 8am scramble for appointments to fixing our staffing shortage by training thousands of new GPs, and from guaranteeing face-to-face appointments for all who want them to bringing back the ‘family doctor’.

Most importantly, though, is his commitment to this publication and his constituents: He will act by "engaging with both the Practice and CQC to ensure the access to care is at the level which patients, rightly, expect and deserve."

A welcome outcome after years of waiting.

We shall continue to monitor the situation and provide further updates when the CQC re-inspects the practice.

Get involved

In the meantime, if you've been affected by the issues at Cardinal Medical Practice, we want to hear from you:

• Share your story with editor@ipswich.co.uk

• Share anonymously here

• Provide official feedback through Healthwatch Suffolk