Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Millcroft Medical Centre on 19 August 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for all the population groups it serves.

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

• Systems were in place to ensure incidents and significant events were identified, investigated and reported. Staff understood and fulfilled their responsibilities to raise concerns and to report incidents. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered in line with best practice guidance. Staff had received training appropriate for their roles and any further training needs had been identified and planned.
• Patients spoke very positively about the practice and its staff. They said they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available, in different languages and easy to understand for the local population.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care. Urgent appointments were available on the same day.
• 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.

However there were areas of practice where the provider should make improvements.

Importantly the provider should;

• Review the extended role of the practice nurses and their responsibilities to ensure the triage role for patients is effective. This should include also the opportunity for setting up clinical supervision practice in their work place to enable them to reflect on their practice.

• Ensure that all the required information is obtained for GP locums to establish their fitness to practice as part of their recruitment process. The practice should also develop a GP locum pack which is specific to this practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Millcroft Medical Centre on 27 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We rated the practice as requires improvement for providing safe services because:

• Patient Group Directions (PGD) had not been appropriately dated, signed and authorised. We noted that staff members names had been added after the date they had been authorised by a GP.
• There was no effective system in place to monitor uncollected prescriptions to ensure vulnerable patients not collecting their medication regularly were referred to the GPs for review.
• The recruitment process was not robust. For example, there was no formal system in place to check at regular intervals the professional registration of clinicians, employment history was not recorded, proof of identity had not been recorded and references had not been sought. The practice did not hold a complete record of staff vaccination histories.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.
• Ensure the recruitment procedure operates effectively and safeguards patients from unsafe care and treatment.

The areas where the provider should make improvements are:

• Review the system for placing alerts on patient records to ensure victims of domestic violence are safeguarded.
• Review the system in place for the monitoring of consent to offer assurance that that consent had been sought from an appropriate adult for a child patient.
• Review how learning, and actions are monitored to mitigate the risk of similar incidents reoccurring.
• Review the criteria used to identify significant events.
• Review the complaints systems to ensure patients were provided with appropriate information with regard to the Parliamentary Health Service Ombudsman (PHSO) and that agreed actions are carried out.
• Continue to review the practice capacity with regard to patient access.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.