Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Kingsbridge Medical Centre on 11 July 2016. The overall rating for the practice was good with requires improvement in providing safe services. The full comprehensive report on the 11 July 2016 inspection can be found by selecting the ‘all reports’ link for Kingsbridge Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 10 May 2017 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 11 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• Improvements had been made in the recruitment of locum GPs however several gaps remained. The practice took immediate action on the day of the inspection to mitigate the gaps and updated their policy for employing agency workers to ensure the safe recruitment of future locum GPs.

• An appropriate emergency medicine was available at the practice to treat possible complications associated with the insertion of inter uterine coils.

• A system had been implemented to monitor and follow up children who did not attend hospital appointments.

• A system had been put in place to regularly monitor fridge temperatures to ensure vaccines were stored within the manufacture’s recommended temperature range.

• A protocol for dealing with uncollected prescriptions had been developed and implemented.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Date all policies to ensure policies are reviewed and updated within an appropriate time frame.

• Ensure the updated policy for the employment of agency workers is fully implemented.

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 Kingsbridge Medical Practice on 11 July 2016. Overall the practice is rated as good.

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.

• Most risks to patients were assessed and well managed.
• 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.
• Not all patients said they found it easy to make an appointment with a named GP.
• 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 one area of outstanding practice:

The practice was involved in an innovative over 75’s project. The practice offered a face-to-face home visit for all patients over 85 years, and for all patients who scored highly in a screening questionnaire. A nurse carried out a two hour holistic biopsychosocial assessment. In 2015-2016, 307 visits were carried out. As a result of these visits, a total of 74 referrals had been made to services such as social services, memory clinic, falls clinic and physiotherapy. The practice had assisted 129 patients with making benefit claims and assisted 61 patients to apply for their blue parking badge.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• When employing locum GPs, have systems in place to assure that all appropriate recruitment checks have been carried out, either by themselves or by the locum GP agency.

• Have medicines available to treat possible complications associated with inter uterine coil fitting (atropine) as per good practice guidelines.

In addition the provider should:

• Develop and implement a robust system to follow up and document outcomes for monitoring children who do not attend hospital appointments.

• Regularly monitor fridge temperatures to ensure vaccines are stored within the manufacture’s recommended temperature..

• Develop and implement a protocol for dealing with uncollected prescriptions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice