Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Melbourne Grove Medical Practice on 8 September 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 though the practice had not implemented the recommendation from their Legionella risk assessment.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Not all patients felt they were treated with compassion, dignity and respect or 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. However we saw that the practice did not provide complaint responses in two out of the three complaints reviewed for over four months.
• Some patients said they had difficulty accessing appointments over the telephone and there was a lack of continuity of care as a result of staff turnover and reliance on locum GPs. Urgent appointments were available the same day.
• 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:

• Review and update the practice’s safeguarding policies with details of all relevant contacts to enable staff to effectively report safeguarding concerns.

• Consider providing customer service training for all staff.

• Comply with the recommendations in the practice’s legionella risk assessment.

• Continue to work on recruiting additional staff to improve continuity of patient care.

• Arrange additional training for practice nurses with higher than average inadequate cervical screening sample rates.

• Continue to work on improving patient satisfaction scores around access; particularly in respect of their ability to contact the practice over the telephone.

• Ensure that the practice's stock of emergency medicines are appropriate to meet the needs of patients requiring emergency treatment.

• Take action to respond to low national patient survey scores and monitor progress.

• Respond to complaints in a timely fashion in accordance with the practice’s complaints policy

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice