Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Malling Health@Stoke Aldermoor on 10 January 2017. 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment. Staff told us due to recent and pending staff resignations, workloads were high which increased pressure on staff.
• 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. A complaints leaflet was available on request, but details on how to complain were not included in the practice leaflet.
• Some patients told us they found the appointment system difficult. Same day appointments were available. Patients were able to make use of an extended hours scheme to access same day appointments between 6.30pm and 9.30pm. This service was delivered via a local GP alliance.
• The practice premises were leased from NHS Properties. We saw there was need for refurbishment in some areas. The practice showed us an improvement action plan which evidenced that NHS Properties had been approached to effect these improvements.
• The practice was part of Integrated Medical Holdings (IMH) organisation. Clinical staff and the practice manager worked across Malling Health @Stoke Aldermoor and their sister practice Malling Health@Foleshill.
• IMH had a clear leadership structure and governance framework. Staff told us they had little contact with senior managers from the organisation. However they told us they felt supported by the practice manager and senior GP in the practice.
• The practice told us they had endeavoured to establish a patient participation group (PPG). At the time of our visit this had not been achieved. They told us they found it difficult to engage patients in the process. They received patient feedback via the NHS Friends and Family test, as well as via a suggestion box in the waiting area, and by carrying out internal patient satisfaction surveys.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Review their appointment system to enhance patient experience of access to same day appointments.

• Continue with a programme of recruitment of clinical staff to augment the clinical team.

• Continue to engage with patients to establish and develop a patient participation group.

• Take steps to improve patient’s awareness of the practice’s complaints process.

• Continue to carry out or at least comprehensively risk assess the need for enhanced disclosure and barring service (DBS) checks for all staff acting in the role of chaperone.

• Develop systems to improve the identification of those patients acting as unpaid carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice