This service is rated as Good overall.

The key questions 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 Primary Care Access Hub - Meir Primary Care Centre on 10 March 2018 as part of our inspection programme.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for recording, reporting and learning from significant events. When incidents did happen, there were arrangements in place to ensure learning was shared to improve processes.
• There were systems in place to keep patients safe and safeguarded from abuse and for identifying, assessing and mitigating risks to the health and safety of patients. However, the oversight of safety checks needed strengthening.
• There was a system in place that enabled sessional GPs providing treatment to access patient electronic records. Written agreements were in place for sharing information with staff and external partners to enable them to deliver safe care and treatment.
• The service managed patients’ care and treatment in a timely and effective way.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
• Patients told us they felt listened and involved in their care and treatment and were treated with compassion, kindness, dignity and respect. They spoke highly of the care and treatment they had received and told us they would highly recommend the service.
• The service worked proactively with other organisations and providers to ensure patients had access to alternatives to hospital admission or urgent care services where appropriate, which improved the patient experience.
• The service sought feedback from staff and patients, which it acted on.
• There was a clear leadership structure and staff felt supported in their work. There was a strong focus on learning and improvement and a commitment to improve continuing care for local patients in addition to reducing demand on other parts of the healthcare system such as A&E services.
• The service only employed local GP partners and salaried GPs who were therefore familiar with all the local systems, referral pathways and prescribing formulary. The service had a comprehensive system for post consultation messaging to local GP practices with frequent examples of personalised follow up by a clinical director. For example, telephone calls were made to patients registered practice to confirm urgent referrals had been made or investigation requests actioned to ensure continuity of care.
• The service had a detailed and extensive customisation of directory of services with the local NHS 111 service to ensure only the patients that would benefit from this service were provided with an appointment.
• There was a detailed and systematic review of the quality of consultations undertaken by a clinical director providing evidence of individual feedback and learning.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Review policies to ensure they are specific to the service, inform practice and are dated to ensure they are reviewed and updated within an appropriate time frame and reflect latest guidance.

• Develop documented systems to gain assurances that safety checks on emergency medicines, equipment and health and safety checks are carried out and actioned at the premises where the service is delivered from.

• Review significant events to ensure they are recorded in line with policy.

• Review the complaint policy to ensure people who complain are advised of the escalation process and ensure complaints about clinical matters are considered and investigated as significant events.

• Review the system for receiving and acting on external safety alerts.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice