Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Drs Oram, Walton, Hynes & Dutton on 4 October 2016. The overall rating for the practice was Good. However, the practice was rated as requires improvement for providing safe services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Drs Oram, Walton, Hynes & Dutton on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 7 February 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 4 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had updated its emergency drugs policy which now specifically stated that a medicine which may be required following coil fitting was to be stocked. We saw the practice had stock of emergency medicines appropriate to the practice.

• The practice had reviewed its policy for processing blood test results. The policy stated that all incoming test results were to be processed within 48 hours. The practice had carried out regular audits to ensure they were adhering to this standard.

• The practice had re-designed its minor surgery consent form which included advice leaflets for specific procedures advising patients of the process and the risks. Records we looked at showed that comprehensive assessment of patients pre-operatively and consent was in place on the three cases sampled. There was comprehensive clinical records and appropriate referral of samples for analysis.

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 Drs Oram, Walton, Hynes & Dutton on 4 October 2016. Overall the practice is rated as good.

The practice has two locations 14 Horseley Heath, Tipton and their sister practice Tandon Medical Centre. The practice has one patient list and patients can be seen by staff at both surgery sites. Systems and processes are shared across both sites. During the inspection we visited both locations. As the locations have separate CQC registrations we have produced two reports. However where systems and data reflect both practices the reports will contain the same information.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and generally well managed however, during the inspection we identified that a number of blood test results recorded on the practice computer system had not been actioned for six working days. We discussed this with the practice who took immediate action including reporting this as a significant event to the CCG..
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients 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.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw several areas of outstanding practice:

• There were video clips on the website produced by one of the GPs to help educate patients about recognising symptoms and how to access help. One video had led to 4 families taking their children to hospital with early symptoms of mengitis. All of the diagnoses were confirmed however there were no long terms effects due to the early treatment which was provided. The Royal College of General Practitioners (RCGP) Midland Faculty Quality in GP Education had awarded a prize in 2016 for the “When should I worry” advice clip.

• The practice had undertaken a “Food First” campaign specifically targeting older patients in care homes where SIP feeds were being prescribed to aid nutrition in people losing weight. Care staff at the nursing homes involved had received advice about how to fortify food and the number of prescriptions for SIP feeds had been reduced. This work was highly commended by the Clinical Commissioning Group (CCG).

The area where the provider must make improvement are:

• Ensure risks are considered and mitigated in relation to the availability of emergency medicines .

The areas where the provider should consider making improvements are:-

• A written consent form should be used for patients providing consent for more invasive minor surgery.

• Continue to review the procedure in place for acting on patients test results to ensure that it is effective and timely.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice