Letter from the Chief Inspector of General Practice

In December 2014, we found concerns related to staff recruitment check and records, access to phone translation services and the patients understanding of the advanced appointment booking system during a comprehensive inspection of Wellington House Practice, Princes Risborough, Buckinghamshire. Following the inspection the provider sent us an action plan detailing how they would implement systems to ensure staff recruitment checks and records would be reviewed and improved. They also confirmed that all staff would be made aware of the translation service to offer to patients if their first language was not English. The action plan outlined how the practice would improve patient understanding of the advanced appointment booking system.

We carried out a desktop review of Wellington House Practice on 16 April 2016 to ensure these changes had been implemented and that the service was meeting regulations. Our previous inspection in December 2014 had found a breach of regulations relating to the requirement of workers. The ratings for the practice have been updated to reflect our findings. 

We found the practice had made improvements since our last inspection on 17 December 2014 and they were meeting the regulation relating to recruitment checks and records that had previously been breached.

Specifically the practice was operating safe systems in relation to staff recruitment and records. This included:

• All nursing staff had received Disclosure and Barring Service Checks. The practice had risk assessed all staff roles to determine which staff required DBS checks, including those undertaking chaperone duties.
• Locum references are taken and the practice has processes to assure themselves that the appropriate recruitment checks were undertaking by employment agencies.
• Staff recruitment checks had been updated to ensure all references are taken for newly appointed staff and gaps in employment are checked.

The practice has also ensured that all staff are aware of the translation service available to patients, whose first language is not English. A patient information leaflet has been created to explain the appointment system to all patients, which includes how to book advance appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We inspected Wellington House Practice on 17 December 2014. This was a comprehensive inspection. The practice has a branch location which was not inspected as part of this inspection.

Overall the practice is rated as good. Specifically, we found the practice to be good for providing caring, responsive and effective services and for being well led. It requires improvement in order to ensure safe services are provided.

Our key findings were as follows:

The practice provided good care and treatment to its patients. National data showed the practice performed above the national average in managing long term conditions. Patients reported that they could access the practice and the system of phone triage worked well, (the triage system was usually a phone consultation with a GP to determine what assistance a patient needs), although some patients who worked said the system could be difficult for them. The premises were accessible, clean and safe. Medicines were checked and stored safely. Staff were aware of the needs of their patients including small numbers of vulnerable patients such as those who were homeless or travellers. The practice was responsive to potentially vulnerable patients and considered their needs in the planning of its services. The practice achieved the best outcomes for managing diabetes in the clinical commissioning group (CCG). The practice used telehealth which can assist GPs in gaining specialist advice on treating and caring for long term conditions and can reduce the need for referrals to hospitals or other services. There were clear leadership structures and an open culture which was inclusive and encouraged staff to participate in the running of the practice. A patient participation group (PPG) was consulted to assist the leadership in making improvements to the service.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• ensure employment checks are undertaken for all staff as required, including criminal record checks, references and employment histories.

In addition the provider should:

• ensure staff know the phone translation service is available to support patients to access the service who do not speak English
• ensure patients are aware that appointments can be booked in advance in order to provide greater flexibility in seeing GPs and nurses

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice