Letter from the Chief Inspector of General Practice

Our previous inspection in July 2015 found breaches of regulations relating to the safe delivery of services.

We found the practice required improvement for the provision of safe services, and was rated good for providing effective, caring, responsive and well-led services. The population groups were rated as good for the patients registered at the practice.

This inspection was undertaken to check the practice was meeting regulations. For this reason we have only rated the location for the key questions to which these relate. This report should be read in conjunction with the full inspection report of 30 July 2015.

We found the practice had made improvements since our last inspection. At our inspection on the 20 January 2016 we found the practice was meeting the regulations that had previously been breached.

Specifically we found:

• Most of the staff had undertaken safeguarding children and adult training and the remaining staff were due to attend refresher training course in February 2016.
• Improvements had been made to maintain the accurate records of patient information. For example Read Codes had been properly recorded of all patients on child protection register and audit had been carried out to ensure continuous monitoring.
• The practice had revised protocol for handling blank prescription forms in accordance with national guidance.
• The practice was actively identifying, assessing and managing risks to prevent, detect and control the spread of infections.

However, the areas where the provider should make improvements are:

• Review the processes for continuous and effective monitoring of safeguarding training for all staff.
• Implement the process for the tracking of hand written prescription forms.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe services.

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 Dr Shirley Tinnion & Partners (also known locally as Meadowcroft surgery), Jackson Road, Aylesbury, Buckinghamshire, HP19 9EX on 30 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to require improvement for provision of safe service. It was good for providing effective, responsive, caring and well led services.

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

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. The majority of information about safety was recorded, monitored and reviewed, appropriately. When issues were identified they were addressed with the exception of child protection safeguarding alerts and safety and security of prescriptions.
• Risks to patients were assessed and well managed in some areas, with the exception of those relating to infection control. For example, the practice had not carried out follow up infection control audit or risk assessment and some actions were still outstanding from previous audit.
• Data showed patient outcomes were 78% on average for all long term condition medicine reviews. However, we saw the practice had implemented a care planning project for patients with diabetes and the practice was expecting improved outcomes for diabetes patients in the future. The practice was in the process of rolling out similar care planning projects for other patients with long term conditions to improve the outcomes.
• We found that completed clinical audits cycles were driving positive impact on patients outcomes.
• 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.
• Urgent appointments were usually available on the day they were requested. However patients said that they sometimes had to wait for non-urgent appointments with a named GP.
• The practice had good facilities and was well equipped to treat patients and meet their needs. However, the waiting area was congested and there was no low level desk at the front reception. This made communication with reception staff difficult for patients in wheelchairs.
• 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 areas where the provider must make improvements are:

• Ensure safeguarding training is undertaken for all clinical staff.
• Ensure the process for the handling of blank prescription forms are handled in accordance with national guidance as these were not tracked through the practice and kept securely at all times.
• Ensure the practice assesses the risk of, and takes steps to prevent, detect and control the spread of infections, including taking action to resolve identified actions without delay.

In addition the provider should:

• Ensure regular medicine reviews are undertaken for patients with long term condition.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Meadowcroft Surgery on 8 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.