Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Much Hadham Health Centre on 17 November 2016. Overall the practice 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 reporting and recording significant events.
• Risks to patients were assessed and well managed. However the process of managing high risk medication needed strengthening.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. However there was not an accessible summary of training records for the practice.
• Most staff had received an annual appraisal in the past 12 months or had confirmed dates for an appraisal to be completed by 31 March 2016.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.
• The practice had established systems to support carers.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Develop a comprehensive approach to assessing infection control compliance.

• Develop systems to update the practice patient records with the results obtained through the hospital results system for patients receiving high risk medication.

• Continue to monitor the recently implemented protocol to code children who had failed to attend a hospital appointment (DNA) so they can be easily identified and acted on.

• Develop systems to periodically corroborate through a laboratory check the test results of patients who self monitor their blood when receiving anticoagulants.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with six patients and five members of staff.

When patients received care or treatment they were asked for their consent and their wishes were listened to. One patient told us: "I tell them to go ahead". We found that when minor surgery had been carried out written consent had been requested from patients before the surgery had commenced.

We saw that patients' views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. The patients we spoke with provided positive feedback about their care. A patient told us: "I think they are very good".

Patients who were registered at the practice received their medicines when they needed them. Patients were able to obtain their prescribed medicines from the dispensary within the practice but medicines dispensed to nearby care homes were not stored or dispensed safely.

Staff had received training in safeguarding children and vulnerable adults. They were aware of the appropriate agencies to refer safeguarding concerns to that ensured patients were protected from harm.

The provider had a system in place for monitoring the quality of service provision. There was an established system to regularly obtain opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff.