Damning report reveals Bedford's Goldington Road Surgery had bullied staff and unhappy patients

Bullied staff, unhappy patients and an absent GP are just some of the many worrying issues raised by health watchdogs at Goldington Road Surgery in a damning report published today (Tuesday).

Back in January, Bedford Today exclusively revealed how the Goldington Road/Dr Das GP practice was due to close at the end of March after the Care Quality Commission (CQC) visited in December and took enforcement action.

At the time, the exact details of what the CQC had found hadn’t yet been made public – well, now they have and it’s a litany of criticism.

You can read the full report here

You can read the CQC’s evidence table here

When the inspectors visited, Dr R Das had been absent from the practice for some months. Locums were then brought in to help the remaining GP partner – Dr V Das.

What the CQC found left it rating the practice ‘inadequate’ overall – as well as ‘inadequate’ in other categories, namely safety, effectiveness and whether it was well-led. It was also rated ‘requires improvement’ when it came to being caring and responsive.

The report states that not only were staff treated poorly, but patients were negative about their treatment.

Inspectors said: “Staff told us they felt they had been, and had seen others being, bullied and scared by some leaders. As a result, staff told us they did whatever leaders asked them to do. Staff described a tense and unprofessional working atmosphere, for example staff would frequently shout at other staff members and patients, including when there were other patients in the practice.

"Staff told us about secrecy around the roles of some staff in the practice.”

And – perhaps more alarmingly – staff told inspectors prior to their inspection they did not have emergency medicines and “they had never seen emergency oxygen or a defibrillator in the practice”.

The CQC also found:

One in three members of staff told us they felt able to raise concerns without a fear of retribution

Staff reported leaders were not always visible and approachable, did not value them, did not give enough attention to their safety and well-being

Patients felt some clinical staff did not care, were rude, impatient, intimidating, unprofessional and dismissive

Complaints were not listened and responded to or used to improve the quality of care and service

And that’s not all: there was no evidence of a DBS check for two of the non-clinical members of staff and two of the clinical members of staff; not all staff had been immunised in line with national guidelines; and much of the required training was lacking.

Inspectors also panned the following:

Staff did not record, control, monitor and store blank prescriptions in ways that minimised their unauthorised access or use

Staff sometimes administered medicines to patients without proper authorisation in place

Appropriate standards of cleanliness and hygiene were not met

Evidence of patchy medicine reviews of patients to avoid dependency

Non-clinical staff regularly worked in the practice, including to carry out clinical tasks with patients, with no clinical staff to support them

Special mention was made of the practice’s dealing with patients who suffered from chronic kidney disease (CKD).

Inspectors said: "Our searches of the practice’s clinical records system found 49 patients whose test results suggested they may have advanced CKD that had not been diagnosed. We looked at the records for five of these patients and found:

• One patient had not had all of the appropriate follow-up investigations

• Two patients were not prescribed appropriate medicines

• The diagnosis for one of the patients could have been made in July 2022. This missed diagnosis meant the patient had not been offered the appropriate yearly review and monitoring.”

Another patient was not monitored after being prescribed Lithium, despite a hospital specialist requesting it. And some patients were not informed of the high risk of birth defects during pregnancy if they took certain prescribed medicines.

A spokesperson for Bedfordshire, Luton and Milton Keynes Integrated Care Board said: “We welcome the detailed report on 12 Goldington Road Surgery by the Care Quality Commission, following concerns raised by the inspectors and ICB with Dr Das.

“Since the CQC’s visit to the practice in December, Dr Das has chosen to resign her General Medical Services contract to provide primary care services from the premises. On receiving this notification, the ICB's immediate focus was to work quickly to transfer all patients to other local practices. This process has now been completed successfully.

“Patient safety and the proper use of public funds are paramount to us. We support practices across Bedfordshire, Luton and Milton Keynes to offer patients safe, effective care which makes judicious use of taxpayers’ money.”