Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Medicare Medical Services LLP (also known as Edmonton GP Walk-In Centre) on 25 March 2017. The centre provides care for unregistered (walk-in) patients. Overall the service 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 recording, reporting and learning from significant events.
• Risks to patients were assessed and well managed.
• Patients’ care needs were assessed and delivered in a timely way according to need.
• 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.
• The service managed patients’ care and treatment in a timely way.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The service told us that its commissioners had only recently requested monthly performance monitoring reports but we did not see evidence that the staff had formally met to review these reports and to see where improvements to the service could be made.

• 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.

• The service was well equipped to treat patients and meet their needs. For example, we noted that the local area was relatively deprived and staff told us that many local people worked zero hour contracts which required attendance at work at short notice. Staff and patients spoke positively about how the service enabled flexible, non appointment based care to be provided which could accommodate patients’ employment commitments.

• There was a clear leadership structure and staff felt supported by management. The service 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.

The areas where the provider should make improvement are:

• Ensure that there are systems in place to ensure that the processes and policies for safeguarding vulnerable adults are kept up to date with latest guidance and legislation.

• Ensure a copy of its Business Continuity Plan is stored off site.

• Consider increasing the use of clinical audit, in order to drive quality improvements.

• Consider developing a performance monitoring protocol to review and assess where improvements can be made; and to enable analyses of how long it takes to be seen at different times of the day.

• Review its protocols to see how it can improve on the time taken for patients’ notes to be sent to their registered GP following a consultation.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

We spoke with five patients who were all happy with the service. Patients were treated with dignity and respect. Patients understood the care and treatment choices available to them and felt they were given appropriate information and support regarding their care or treatment.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual needs. Patients were satisfied with the consultation that they had received by the GP. A patient told us “everything was explained. The GP does their best considering they don’t have my records.” There were arrangements in place to deal with medical emergencies.

Policies and procedures were in place for staff to follow should they have concerns about the safety of children and vulnerable adults. Medicines were handled appropriately and kept safely. Patients told us that they felt the GP had given them enough information about the medicines.

The practice had a policy in place for appointing locum GPs. Recruitment checks were carried out on GPs but there were some gaps in the records kept.