This practice is rated as Requires Improvement overall.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at Brompton Medical Centre on 30 April 2019 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• There was an effective system for reporting and recording significant events.
• The practice’s systems, processes and practices helped to keep people safe.
• Risks to patients, staff and visitors were assessed, monitored and managed in an effective manner.
• Staff had the information they needed to deliver safe care and treatment to patients.
• The arrangements for managing medicines in the practice helped keep patients safe. Where prescribing performance for some antibiotics, some analgesics and some hypnotics were higher than local and national averages, the practice was taking action and had made improvements.
• The practice learned and made improvements when things went wrong.
• Patients’ needs were assessed, but care and treatment were not always delivered in line with legislation, standards and evidence-based guidance supported by clear pathways and tools.
• Performance for diabetes and hypertension related indicators for 2017 / 2018 was below local and national averages. The practice had taken action and unverified data showed that improvements to performance in both these indicators had taken place.
• Published results showed the childhood immunisation uptake rates for the vaccines given were lower than the target percentage of 95% or above in three out of the four indicators.
• Staff had the skills, knowledge and experience to carry out their roles.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
• Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was higher than local and national averages.
• There were clear responsibilities, roles and systems of accountability to support good governance and management locally and at provider management team level.
• Some processes to manage current and future performance were not yet sufficiently effective.
• There were little or no clinical improvements as a result of clinical audit activity.
• The practice had a vision to deliver high quality care and promote good outcomes for patients.
• The practice was proactive at involving patients, the public, staff and external partners to support high-quality sustainable services.

The areas where the provider must make improvements are:

• Ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Revise computerised records so that staff are alerted to family and other household members of child patients that are on the risk register.
• Continue with plans to provide clinical staff with relevant vaccinations in a timely manner.
• Continue to implement and monitor activities to sustain improvements to prescribing performance where these were higher than local and national averages.
• Continue to implement and monitor activities to sustain improvement to performance for diabetes and hypertension indicators that were below local and national averages.
• Continue to identify patients who are also carers to help ensure they are offered appropriate support.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

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