Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park Road Medical Centre on 30 November 2016. Overall the practice is rated as good.

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

• There was a system in place for reporting and recording significant events, although analysis and recording was not always detailed enough to show that all of the risks had been addressed.
• Generally, risks to patients were assessed and well managed, although some had not been addressed comprehensively. For example, although the premises were clean, there was no clear lead for infection prevention and control and although appropriate recruitments checks had been madenot all the checks had been made and fully documented for one member of staff before they started in post.
• 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.
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes on most indicators were at or above average compared to the national average. The practice was an outlier for diabetes indicators in 2014/15 and took action to improve – results in 2015/16 were generally in line with averages. The percentage of patients diagnosed with dementia who had a face-to-face review of their care was below average in 2015/16. We saw evidence that action had been taken, and results were likely to be in line with average in 2016/17.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the national GP patient survey showed patients rated the practice higher than others for several aspects of care. Satisfaction with nursing care was below average in the survey data published in July 2016. The practice had taken action to improve the nursing service, including employing an additional nurse and providing more support and training.
• 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 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Consider the level of detail recorded for significant events, so that all of the analysis is evident.

• Ensure that risks are comprehensively assessed and managed. Strengthen arrangements for infection prevention and control and ensure that recruitment checks are carried out and fully documented before staff begin in post.

• Continue to monitor and take action to improve care of patients with long term conditions, particularly diabetes and dementia.

• Continue to monitor and take action to improve patient satisfaction with the nursing service.

• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice