A GP practice in Richmond has been told it needs to improve by a health watchdog.

Dr Antoine Sayer, also known as The Richmond Green Medical Centre, was rated 'requires improvement' in a report published by the Care Quality Commission last month.

Inspectors graded the surgery in The Green as 'requires improvement' for safety, effectiveness and being well-led, as well as across six population groups encompassing older people, people with long term conditions, families and children, working aged people, vulnerable people with poor mental health.

It was, however, judged 'good' for caring and being responsive to people's needs.

The practice - which looks after 1,600 patients with one full-time GP, one long-term locum GP, a healthcare assistant and a phlebotomist - was visited in November last year.

In his report summary, chief inspector of general practice Professor Steve Field wrote: "Risks associated with the practice's processes were not always fully recognised and addressed. In particular, the practice's arrangements for triaging patients for appointments, managing prescription stationary and uncollected prescriptions, and ongoing review and management of patients' conditions required further consideration in order to manage risks."

The report said the practice’s appointment system “did not set aside appointments for same-day bookings”.

A lack of stringent controls for managing prescription pads and uncollected prescriptions was also noted; prescriptions were kept in a locked cupboard rather than a locked room and there was no log of the prescription pads issued to staff.

A highlighted issue was the lack of a nurse because, “the principal GP had been providing services which would usually be undertaken by a nurse, such as immunisations and taking cervical screening samples.

“The practice was unable to demonstrate that the GP had completed specific training and carried-out activities to stay up to date with current guidance relating to these activities.”

It added that there was no female cervical screening sample-taker available and the uptake for cervical screening was 70 per cent, which was below the 80 per cent target for the national screening programme.

The surgery did tell the inspectors that it was 'in discussions with a nearby practice about sharing their nurse'.

The proportion of broad-spectrum antibiotics prescribed (antibiotics which act against a wide range of bacteria, but which may contribute to antibiotic resistance) was 11 per cent compared to a national average of five per cent.

In the report, the practice said its higher use of broad-spectrum antibiotics was because they were prescribed to patients at a neuro-disability nursing home, where broad-spectrum antibiotics are often more appropriate.

For serious mental health issues, the practice fared better. The report noted that 94 per cent of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the previous 12 months compared to a national average of 90 per cent.

Also, 94 per cent of patients experiencing poor mental health received advice about alcohol consumption compared to a national average of 91 per cent.

Patients who had recently experience bereavement were contacted by the surgery and advised on the best services.

It added: “Staff were consistent and proactive in helping patients to live healthier lives.”

The practice was rated as good for being caring because staff “treated patients with kindness, respect and compassion” and also understanded their patients’ “personal, cultural, social and religious needs”.

The manager of the practice was approached by phone but declined to comment.