Letter from the Chief Inspector of General Practice

We had previously inspected Dartmouth Medical Centre in 10 January 2017 whilst registered under the previous provider. Following this inspection the practice was rated as inadequate and placed into special measures. Since the January 2017 inspection there has been a change to the registered provider. The current provider registered with the CQC in April 2017.

We carried out this announced comprehensive inspection at Dartmouth Medical Centre on 25 October 2017. Overall the practice is rated as good. Our key findings across all the areas we inspected were as follows:

• The provider had a clear vision to improve the practice and promote good outcomes for patients. They were prioritising areas of quality and patient safety and had developed a business plan to support improvement. Strategies had been implemented to minimise risks to patient safety in areas such as patient records and medicines management. However, exception reporting for some indicators remained high. Since the inspection the practice have reviewed the exception reporting rates and found where the errors were occurring and we have received assurances that this has now been rectified.

• On the day of inspection we found documentation for learning reviews were unclear, but since the inspection we have received evidence to confirm that all patients had been reviewed appropriately.

• The practice had a system in place to ensure action was taken following hospital communication and the process was auditable.

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice was proactive in working with other health and social care professionals to safeguard some of the practices most vulnerable patients.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• Single cycle audits demonstrated reference to appropriate national guidance.

• Information about services and how to complain was available.
• Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff members were able to provide examples where a caring and responsive service had been delivered to patients.
• There was a clear leadership structure and staff felt supported by management. The provider planned to merge the practice with another nearby practice (Linkway Medical Practice) where they were a partner and the process had been started through the adoption of policies and procedures and joint management meetings.

The areas where the provider should make improvement are:

• Improve achievement on the GP patient survey.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice