Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woolpit Health Centre on 5 December 2016. The overall rating for the practice was good, with requires improvement for providing safe services. The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for Woolpit Medical Practice on our website at

www.cqc.org.uk

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We undertook a desk-based focused inspection to check they had followed their action plan and to confirm they now met legal requirements in relation to the breach identified in our previous inspection on 5 December 2016. This report only covers our findings in relation to those requirements.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had an effective system in place for monitoring the medicines in GPs bags.

• The practice had updated the medicines searches that were completed quarterly, to ensure that prescribing was in accordance with current best practice. There was an effective policy in place for patients on high risk medicines who had declined to attend for a review.

• Security arrangements for the dispensary had been reviewed and improved. Standard operating procedures had been reviewed and a system was in place to ensure this was completed on a regular basis and dispensing errors were discussed at team meetings.

• The practice had updated the training matrix to include infection control which had been completed by all staff. Infection prevention and control training was booked for July 2017.

Appraisals for most staff had been undertaken. Staff teams undergoing a restructure had undergone an informal appraisal process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woolpit Health Centre on 5 December 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.
• 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 most recent published results from the Quality and Outcomes Framework showed the practice scored 100% of the total number of points available. This was 2% above the Clinical Commissioning Group (CCG) average and 5% above the national average. The overall exception reporting rate was 6%, which was 4% below the CCG and national average.

• The practice could demonstrate improved outcomes for patients as a result of clinical audits, implementing research findings and participating in research. The practice held a weekly journal club, where clinicians and trainees presented and critically appraised articles. Checks were completed to ensure any learning from the research was being undertaken in practice.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had identified 384 patients as carers (3% of the practice list).
• 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.
• The majority of patients said they found it easy to make an appointment with a named GP and 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.
• There was a clear leadership structure, which was being further strengthened with the imminent appointment of a nurse manager. All the staff we spoke with felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on. The practice had a weekly newsletter for all staff which helped staff keep up to date with important information.
• The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider must make improvement is:

• Implement an effective process to ensure that medicines kept in GPs bags are checked routinely to ensure medicines are in date.

The areas where the provider should make improvement are:

• Undertake repeat searches for historic patient safety alerts which may remain relevant.

• Agree and implement a policy for how to manage patients on high risk medicines who decline to attend for a review.

• Review the security arrangements and standard operating procedures for the dispensary on a regular basis. Ensure that all dispensing errors identified are discussed within the practice and audits are undertaken to ensure the quality of the dispensing service.

• Ensure that all staff receive infection control and prevention training.

• Ensure a system is in place for staff development, for example regular appraisals.

We saw one area of outstanding practice:

• The practice subsidised a minibus service from each of the outlying villages to the practice to ensure that patients living in these villages could access the GP practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice