At our previous inspection, we rated the practice as requires improvement for providing safe care and treatment. This was due to concerns that were identified relating to emergency medicines, premises risk assessment and mitigation and due to a breach in regulation of the Health and Social Care act 2012 relating to medicine safety alerts. At this inspection, the practice was able to demonstrate improvement and we rated the practice as good for providing safe care and treatment and overall.

The key questions at this inspection are rated as:

Are services safe? – Good

We carried out an announced focused follow-up inspection at Balsall Heath Health Centre on 26 November 2018.

At this inspection we found:

• The practice had embedded system to ensure that they received, disseminated and learned from medicine safety alerts. Examples we looked at demonstrated that they had been actioned and discussed.
• The practice was able to demonstrate that they held appropriate emergency medicines, in line with guidance and that they had developed a system to ensure they stayed in date and in stock.
• Risk at the practice was identified, assessed and mitigated appropriately and the practice demonstrated that they were seeking assurances from the owners of the building that actions outside of their direct control were being completed.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced inspection at Balsall Heath Health Centre on 31 October 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was a clear leadership structure and staff felt supported by management. Staff spoke positively about working at the practice. We saw that staff were courteous and helpful to patients both attending at the reception desk and on the telephone and that people were treated with dignity and respect.

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.

• During our inspection we found that the practice was not signed up to receive all national safety alerts. Shortly after our inspection took place the practice advised that they had contacted the MHRA alerts team to ensure that they were signed up to all alerts and they implemented additional measures for monitoring alerts.

• There was evidence of some formal risk assessments in place to demonstrate how the practice managed and monitored risk relating to the premises. However it was not clear if actions highlighted on the practice’s fire risk assessment had been completed. In addition, on the day of our inspection there was no evidence to support if regular fire drills had taken place.

• Multi-disciplinary team (MDT) meetings and palliative care meetings took place on a regular basis. Vulnerable patients and patients with complex needs were regularly discussed during the meetings.

• The practice used the information collected for the Quality and Outcomes Framework (QOF) and performance against national screening programmes to monitor outcomes for patients. Data on how the practice was currently driving demonstrated that the practice was meeting QOF targets in most areas at the time of our inspection.

• The results from the most recently published national GP patient survey highlighted that some responses were below local and national averages. However, information and evidence provided by the practice following our inspection demonstrated improved satisfaction in relation to providing a caring service with improved access to services.

However, there were areas of practice where the provider must make improvements:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvement are:

• Ensure that actions are well governed in relation to risk management, including through external risk assessments to assure staff and patients that they are safe.

• Ensure that emergency medicines are adequately managed and monitored with appropriate governance arrangements in place to reflect this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice