Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Portland Medical Centre on 18 February 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.

• Staff understood and fulfilled their responsibilities to raise safety concerns and to report incidents and near misses.
• There were systems in place to maintain the health and safety of patients and staff at the practice and any learning identified from incidents was shared with staff.
• Staff assessed patients’ needs and had effective procedures in place to ensure care and treatment was delivered in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• The practice acted on suggestions received from patients, for example, specific health events and educational evenings and had active support from the Patient Participation Group.
• 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 practice ran warfarin clinics for both the practice patients and people in the local community.
• The practice shared bank holiday opening hours with other practices, so patients could access medical care during this time
• The provider was aware of and complied with the requirements of the Duty of Candour. The practice encouraged a culture of openness and honesty.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating February 2016 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Portland Medical Practice on 1 and 5 November 2018.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• The practice understood the needs of its population and tailored services in response to those needs. There was evidence of a number of projects and services the practice had been involved with to ensure patients’ needs were met.
• The practice was participating in a pilot with MacMillan Cancer Support to develop the role of the Non-Clinical MacMillan Cancer Care Lead, to support newly diagnosed patients.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The system for on the day appointments had changed to a triage system in which reception staff had been in receipt of appropriate training and guidance.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Carry out a risk assessment for those members of staff where a disclosure and barring service check had not been completed.
• Document a risk assessments for those staff whose immunisation status was not known, until the complete immunisation status for all members of staff has been obtained.
• Develop an asset register for all equipment held at the practice.
• Carry out a risk assessment to determine the choice of medicines for use in a medical emergency.
• Demonstrate the competence of staff employed in advanced roles by audit of their clinical decision making.
• Include information about escalating complaints to the Parliamentary and Health Service Ombudsman in the complaint response letters.
• Record detailed minutes of meetings including the attendees, any actions, timescales and review dates.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.