We carried out an announced focused inspection at Redburn Park Medical Centre on 25 April 2019 to check that the practice had made improvements following our previous inspection in January 2019.

At the last inspection on 30 January 2019 we rated the practice as requires improvement for providing safe services because:

• The practice did not have appropriate systems in place for the safe management of medicines.
• There were gaps in the systems to assess the risk of, prevent, detect and control the spread of infections.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall (previous rating – January 2019 good) and now good for providing safe services.

We rated the practice as good for providing safe services because:

• The practice had taken action to address all concerns and had implemented safe arrangements to manage infection control and medicines.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Redburn Park Medical Centre on 30 January 2019 as part of our inspection programme (Previous rating March 2015 – outstanding overall and for providing responsive and well led services, and good for providing safe, effective and caring services).

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups, except families, children and young people, which we rated as outstanding. However, we rated the practice as requires improvement for providing safe services.

We rated the practice as outstanding for providing responsive services for families, children and young people because:

• The practice had responded to the needs of children and young people with poor mental health and had developed accessible information packs for children and their parents; these packs included guidance on where and how to get support, the packs had been noted as good practice and had been adopted by six other practices in the locality.
• There was a high teenage pregnancy rate in the local area; the practice provided highly responsive services for young women to help address this issue.

We rated the practice as requires improvement for providing safe services because:

• The practice did not have appropriate systems in place for the safe management of medicines.
• There were gaps in the systems to assess the risk of, prevent, detect and control the spread of infections.

We rated the practice as good for providing effective, caring, responsive and well led services because:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw some areas of outstanding practice including:

The practice effectively engaged with the local population, to ensure that despite the high levels of deprivation and child poverty, low employment rates and a transient population (10% turnover each year), the practice achieved 100% of the QOF points available. The exception reporting rate was well below local and national averages (exception reporting is the removal of patients from QOF calculations where, for example, the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate) and there was a high childhood immunisation uptake rate.

There were high levels of teenage pregnancies in the local area. One of the practice nurses was a trained sexual health nurse who was able to provide advice and guidance, as well as fitting contraceptive implants. Urgent appointments were made available every day, for example, for those patients who needed their contraceptive injection renewed. An embargoed appointment slot was in place each week for fitting contraceptive implants.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Redburn Park Medical Centre on 24 March 2015. Overall the practice is rated as outstanding for providing responsive services and for being well-led They are rated good for providing safe, effective and caring services. An innovative, caring, effective, responsive and well-led service is provided that meets the needs of the population served.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised, external agencies were informed of the outcome if they were involved. There were strong comprehensive safety systems in place.

• The practice had scored very well on clinical indicators within the quality outcomes framework (QOF). They achieved 99.9% for the year 2013/14, which was above the average in England of 94.2%. QOF is a voluntary incentive scheme for GP practices in the UK. The scheme financially rewards practices for managing some of the most common long term conditions and for the implementation of preventative measures.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients commented that they thought they received a very good service from the practice.

• The practice had good facilities and was well equipped to treat patients and meet their needs. Patients we spoke with and comments cards indicated that it was relatively easy to obtain an appointment.

• The practice had a clear vision which had quality and safety as its top priority. The practice had a six monthly strategic action plan in place which was monitored using QOF, patient surveys and staff feedback. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• The practice offered services which were planned and delivered to meet patient’s needs. For example, they recognised they had higher levels of teenage pregnancy. They trained staff and ensured they had accessible services which were available for this group of patients, including access to a dedicated midwife, who could offer support.

• The practice were committed to the care of patients experiencing dementia. They had the highest dementia diagnosis rate in the clinical commissioning group (CCG) area. The CCG target was 66.7% and the practice achieved 100%, the CCG had complimented the practice in achieving this. To validate the dementia register the practice used their computer systems and were able to identify any patients who may be missing from the register and needing support, for example, patients with memory loss, this helped to make their register as accurate as it could be.

• The practice provided a practice approach to understanding the needs of those experiencing severe mental health. They had the highest prevalence of those experiencing severe mental health in the CCG area; however had the highest percentage in the area for performing reviews for these patients, 98.1% (England and CCG averages 75%). They also provided monitoring for patients who failed to attend secondary care appointments with severe mental health who had been discharged from their care in conjunction with the community matron.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice