We carried out an announced focused inspection at Billericay Medical Practice on 26 September 2017. The overall rating for the practice was good, although we rated safe as requires improvement. At that inspection, we were inspecting to check that the practice had carried out their plan to meet the legal requirements in relation to breaches identified at our earlier inspection of 11 July 2016. The full report on the September 2017 inspection can be found by selecting the ‘all reports’ link for Billericay Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 16 April 2018 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 26 September 2017. This report covers our findings in relation to those requirements.

Overall, the practice continues to be rated as good overall and safe is now rated as good.

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

• Clinicians were prescribing medicines in accordance with manufacturer and other guidelines.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Billericay Medical Practice on 11 July 2016. The overall rating for the practice was good. Safe, caring, responsive and well-led were rated as good and effective was rated requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Billericay Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 26 September 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 11 July 2016. This report covers our findings in relation to those requirements and also additional improvements or risks identified since our last inspection.

Overall, the practice is now rated as good although safe is now rated as requires improvement.

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

• There were arrangements in place to monitor patients taking certain medicines.
• The practice continued to identify patients who had a role as a carer. The practice had now identified 122 patients who also had a role as a carer. This amounted to 1% of the practice population.
• Not all clinicians at the practice were prescribing medicines in accordance with manufacturer and other guidelines.

There were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

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

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Billericay Medical Practice on 11 July 2016. Overall the practice is rated as good, with safe, caring, responsive and well-led services rated as good. Effective services are rated as requiring improvement.Our key findings across all the areas we inspected were as follows:

• There was an effective system in place for recording significant events. A comprehensive analysis took place, and there was evidence of review and shared learning.

• The practice had systems, processes and practices in place to keep patients safe and safeguarded from abuse. There was an experienced lead clinician in place for adult and child safeguarding. Staff were confident in raising their concerns.

• Risks to patients at the premises were well assessed and well managed. There was a lead member of administrative staff for Health & Safety. They had implemented a robust system of monitoring, reviewing and auditing risks to patient safety.

• The practice did not routinely request confirmation of blood test results before generating a repeat prescription. The practice had identified issues with blood tests for certain medicines and had raised concerns with the local hospital at the time of our inspection.

• Carers were identified and supported. A member of administrative staff had been appointed as carers’ champion.

• Results from the national GP patient survey published in January 2016 showed patients responded positively to questions about their involvement in planning and making decisions about their care and treatment.

• The practice was responsive to the needs of the practice population. The premises were accessible and information and services were available on-line, in person or on the telephone.

• The practice valued patient feedback; the Patient Participation Group were active and involved.

• Staff felt supported and valued. There was an open and honest culture at the practice.

The areas where the provider must make improvements are:

• Implement an effective system for the reviewing and monitoring of patients taking high risk medicines.

The areas where the provider should make improvements are:

• Take steps to identify and support more patients who have a caring role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we looked at the two areas where we had previously found the provider to be non-compliant in February 2014. The provider submitted an action plan stating they would achieve compliance by the middle of April 2014. On our return we found the consultation rooms were bright, clean and tidy. The provider had introduced systems to manage and monitor the prevention and control of infections and to identify out of date medication and equipment.

We found people received individualised care and treatment that was planned and agreed with them. Health files were detailed and showed people received continuity of care between professionals and specialist services.

The minor surgery treatment room was clean but the GP consulting rooms were dusty. There were no systems in place to manage and monitor the prevention and control of infection.

Staff had appraisals and attended training and development courses. They told us they enjoyed their work and felt supported and valued by the provider. A staff member said, “We as nurses work well as a team. We can go to the doctors and get advice.” People we spoke to told us, “The doctors are really good,” and explained how the doctors and nurses spent time with them and supported them in the choices they made.