We carried out an announced comprehensive inspection at Govind Health Centre on 12 July 2017. The overall rating for the practice was good but required improvement for providing safe services.

The full comprehensive report on the 12 July 2017 inspection can be found by selecting the ‘all reports’ link for Govind Health Centre on our website at www.cqc.org.uk.

This desk-based review was 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 12 July 2017. 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:

• Immediately following the previous inspection the practice ran searches and identified one patient that had been affected by an alert. This patient was contacted by letter and informed of the action to take.
• The practice had put in place systems and processes to ensure that all safety alerts were managed, reviewed, actioned and communicated to all relevant staff and patients, and had installed an additional computer system to support this.
• The practice had put in place the formal recording of meetings. Examples of this were the weekly clinical meetings where safety alerts were discussed.
• The patient participation group had a schedule of meetings in place and the practice continued to try to increase the membership.
• Minutes of all meetings were now produced in a standard template and action points were recorded.

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 Govind Health Centre on 12 July 2017. Overall the practice is rated as good but required improvement for providing safe services.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined systems to minimise risks to patient safety, although the system for recording actions taken following safety alerts did not demonstrate that these had all been addressed. However, the practice reviewed this promptly and submitted evidence that demonstrated no patients had been at risk.

• 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.
• Results from the national GP patient survey published in July 2017 showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and we saw that complaints had been addressed appropriately within the appropriate timescales. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they had not found difficulty in making an appointment. They told us the practice offered a triage system which allowed the GP to assess whether they needed to see patients which made 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 sought feedback from patients although members of the Patient Participation Group (PPG) told us that the PPG meetings had been less frequent.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvement are:

• Ensure care and treatment is provided in a safe way to patients, specifically to monitor the system for managing safety alerts to ensure the process is consistent and embedded in practice.

The areas where the provider should make improvement are:

• Re-establish meetings with the PPG and continue to seek views of patients regarding the services offered.
• Introduce more structured and formal recording of all practice meetings to demonstrate actions and outcomes.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice