Letter from the Chief Inspector of General Practice

We previously carried out a comprehensive inspection of Moss Valley Medical Practice on 29 April  2015. The overall rating was good.

We carried out a focused inspection of Moss Valley Medical Practice on 7 November 2016, in response to some shared concerns around the handling of acute prescriptions and significant events. We visited the practice as part of this inspection.

We reviewed the practice against two of the five questions we ask about services: are services safe and well-led. The overall rating was good. Our key findings were as follows:

• Most patients we spoke with were very satisfied with the care and treatment they received.

• Moss Valley Medical Practice merged with Gosforth Valley Medical Practice in April 2016, to form a main practice and a  branch surgery. Essential changes were being made following the merger to align the practices

  to 

  ensure a consistent approach to managing the services. Standard procedures and systems were being put in place to ensure the services are safe and well-led. 

• The practice had systems in place to ensure prescriptions were provided in accordance with patient need. The policy relating to issuing of prescriptions needed to be updated, to reflect the current process for providing acute prescriptions to patients in care homes. 

• There was an open culture to reporting safety incidents and near misses. Significant events were appropriately managed and action was taken to prevent further incidents. However, the policy was not up-to-date as it did not detail the processes followed in practice for reporting, recording, and acting on significant events. Following the inspection, we received a copy of the updated policy.   

The areas where the provider should make improvements are:

• Review the policies around prescribing to ensure these describe all processes followed in practice.

• Align and strengthen the systems for managing and monitoring significant events and safety incidents. 

​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 Moss Valley Medical Practice on 29 April 2015. Overall the practice is rated as Good.

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

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. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments 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 management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw several areas of outstanding practice:

• The use of a community pharmacist had improved outcomes for patients including, safer medicines management, reduced emergency admissions and greater cost effectiveness of medicines. For example data showed that Emergency admissions for patients aged 65-75 amongst the lowest in the CCG area at 230 admissions per 1000 patients compared to a CCG average of 250.
• The practice had proactively provided clinics in the community to avoid patients needing to be referred to secondary care. For example; GP’s with special interest and additional training provided additional services, such as dermatology and musculoskeletal clinics to be provided from the practice enabling treatment to be provided more promptly. This service provision had resulted in the practice having the lowest rate of dermatology referrals to secondary care in the CCG area. The CCG rate of referral was 17 per 1,000 patients and practice rate 7 per 1,000 patients.
• Weekly care home ward rounds and medicines reviews by a prescribing pharmacist employed by the practice, as well as robust joint working between practice and community staff had reduced emergency admissions. A&E admissions were particularly low for patients aged 65 and over and 75 and over at 230 per 1,000 patients and 350 per 1,000 patients. The local CCG average was 250 and 400 per 1,000 patients respectively.

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

Importantly the provider should;

• Develop a system for recording what training has been completed and what is still required by staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice