Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bellevue Medical Practice on 23 August 2016. The practice was rated requires improvement for providing safe services with an overall rating of good. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Bellevue Medical Practice on our website at www.cqc.org.uk.

This inspection was a follow up focused inspection carried out on 29 November 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 23 August 2016. This report covers our findings in relation to those requirements.

We found the practice had taken action to address areas where improvements were needed. The practice had made extensive changes which had resulted in significant improvements for providing safe services.

Our key findings were as follows:

• Effective systems and processes had been implemented to ensure patients who were prescribed high risk medicines received monitoring in line with national guidance.

Janet Williamson

Deputy Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bellevue Medical Practice (known as Bellevue Medical Centre) on 23 August 2016. The overall rating for this service is good.

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

• A system was in place for reporting and recording significant events, keeping these under review and sharing learning where this occurred.
• Although processes and procedures were in place to keep patients safe these had not been followed for all patients prescribed high risk medicines.
• The practice was aware of and provided services according to the needs of their patient population. This included transient patients such as students, asylum seekers and refugees.
• Staff received regular training and skill updates to ensure they had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Regular meetings and discussions were held with staff and multi-disciplinary teams to ensure patients received the best care and treatment in a coordinated way.
• Patients told us they were treated with dignity and respect and that they were fully involved in decisions about their care and treatment.
• Information about services and how to complain was available and easy to understand. Patients told us that they knew how to complain if they needed to.
• The practice had an active Patient Participation Group (PPG). The PPG were proactive in representing patients and assisting the practice in making improvements to the services provided.
• There was a clear leadership structure and staff told us they felt supported by management. The practice proactively sought feedback from patients, which it acted on. Staff appeared motivated to deliver high standards of care and there was evidence of team working throughout the practice.

We saw several areas of outstanding practice including:

• Care and support was provided for patients at a local asylum dispersal centre. Specialist weekly clinics were provided at the centre to establish trust and maintain continuity among patients. At the time of the inspection there were 14 different communities using the centre.
• The practice worked with a faith-based charity distributing meals to homeless people. They also engaged in a project to reduce avoidable deaths in homeless people by prescribing an injection that could save their lives in the event of an accidental overdose and also reduce hospital admissions.

The area where the provider must make improvements are:

• Ensure that the systems and processes to address risks associated with high risk medicines are implemented to ensure patients’ safety at all times.

Janet Williamson  

Deputy Chief Inspector of General Practice