Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Milehouse Medical Practice on 5 September 2017. Overall the practice is rated as good.

Milehouse Medical Practice was previously registered with the Care Quality Commission (CQC) as a single handed GP practice as Dr Latif Hussain. We carried out a comprehensive inspection of the previous provider, Dr Latif Hussain, on 4 August 2015 and rated the practice as requires improvement overall with requires improvement for providing safe and well led services. A follow up comprehensive inspection was carried out on 18 August 2016 and the practice was rated as requires improvement overall with requires improvement for providing safe and effective services and inadequate for providing well led services. We issued a warning notice for Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good Governance, and a requirement notice for Regulation 12, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe Care and Treatment. We carried out a focused inspection on 10 January 2017 to check that the practice had taken urgent action to ensure they met the legal requirements of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good Governance and saw that they had. Since our inspection on 10 January 2017 a change of provider has taken place at the practice. The reports for the inspections carried out on 4 August 2015, 18 August 2016 and 10 January 2017 can be found by selecting the ‘all reports’ link for Dr Latif Hussain on our website at www.cqc.org.uk.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. The practice maintained a spreadsheet of significant events however there was a lack of overall structured analysis to identify trends within the practice.

• The practice had defined and embedded systems to minimise risks to patient safety.

• Clinical staff had received appropriate immunisations against health care associated infections however, non-clinical staff had not. A risk assessment had not been completed to demonstrate how potential risks to staff and patients would be mitigated.

• Recruitment information obtained by the practice was not always available in staff records.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey published in July 2017 showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. Feedback from patients about their care was consistently and strongly positive.
• Information about services and how to complain was available.
• Data from the national patient survey, the practice’s survey and CQC patient comment cards showed that patients found it very easy to make an appointment with a GP, there was continuity of care and 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 leadership structure and staff felt supported by the management.
• The practice proactively sought feedback from staff and patients, which it acted on.

• The Patient Participation Group (PPG) had reduced to only one member. The practice was exploring options of how to increase the PPG membership and had highlighted this as a challenge in their business plan.

The areas where the provider should make improvement are:

• Carry out an overall structured analysis of significant events to identify any trends.

• Complete a risk assessment to demonstrate how potential risks to patients and staff will be mitigated from non-clinical staff who have not received appropriate immunisations against health care associated infections.

• Ensure that recruitment information obtained by the practice is stored in all staff files.

• Continue to explore options of increasing the membership of the PPG.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice