Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hagley Surgery on 4 October 2017. Overall the practice is rated as good.

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

• The practice was one of the founding members of the Wyre Forest Health Partnership (WFHP), which comprised six sites. Functions such as human resources and finance were carried out by staff at the WFHP main office, which was located at the Bewdley site.
• There was an open and clear approach to safety and an effective system for reporting and recording significant events, which were discussed at practice and at WFHP board level, so that learning was shared across the six sites.
• Risks to patients were assessed and generally well managed.
• Alerts from the Medicines and products Regulatory Agency (MHRA) had not been recorded since January 2017.
• Emergency medicines were stored in three separate locations in the practice and one emergency medicine was held in a locked cupboard.
• Uncollected prescriptions were checked on a weekly basis and were destroyed after six months, but were not referred to a GP before destruction, apart from prescriptions for controlled drugs.
• There was a prescription delivery system for housebound patients who had late home visits and had no one who could pick up medicines for them.
• Staff had the skills and expertise to deliver effective care and treatment to patients in line with current evidence based guidance.
• Routine appointments with a GP were 15 minutes long, instead of the standard 10 minutes.
• Results from the National GP Patient Survey published in July 2017 showed that patients thought that they were treated with compassion, dignity and respect and that clinical staff involved then in decisions about their care and treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said that they found it relatively easy to make an appointment with a named GP and that there was continuity of care. Urgent appointments were available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear and visible leadership structure and staff said that they felt supported by the GP partners and management team.
• The provider was aware of the requirements of the duty of candour.

The area where the provider must make improvement is:

• Ensure care and treatment is provided in a safe way to patients. In particular, alerts from the Medicines and Healthcare products Agency need to be recorded and actioned.

The areas where the provider should make improvement are:

• Review the system for checking uncollected prescriptions to include referring to a GP before destruction in all cases.
• Review the system for storing emergency medicines so that they are centrally located for ease of access in an emergency.
• Review the procedure for recording discussions at meetings to consider keeping a full account of the decisions and learning outcomes so that there is an audit trail.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice