Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wrenbury Medical Centre on 14th March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Significant events had been investigated and action had been taken as a result of the learning from events.

• Systems were in place to deal with medical emergencies and all staff were trained in basic life support.

• There were systems in place to reduce risks to patient safety. For example, infection control practices were generally good and there were regular checks on the environment and on equipment used. Some staff required further training in the prevention of infection control and protocols around staff handling samples required putting in place.

• Staff assessed patient’s needs and delivered care in line with current evidence based guidance.

• Feedback from patients about the clinical care and treatment they received was very positive.

• Data showed that outcomes for patients at this practice were similar to locally and nationally reported outcomes.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Staff felt well supported in their roles; however additional training was required in some areas.

• Patients said they were treated with dignity and respect and they were involved in decisions about their care and treatment.

• Feedback from patients showed that there were very high levels of satisfaction with access to appointments and they had no difficulty contacting the practice and speaking to clinicians.

• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.

• Information about services and how to complain was available. Complaints had been investigated and responded to in a timely manner; some minor complaints were not recorded.

• The practice had vision to expand and staff strived to provide high levels of service, however there was no documented vision on which to base staff objectives.

• There was a clear leadership and staff structure and staff understood their roles and responsibilities.

• The practice provided a range of enhanced services to meet the needs of the local population.

• The practice sought patient views about improvements that could be made to the service. This included the practice having and consulting with a patient participation group (PPG).

We saw one area of outstanding practice:

• Access for patients to appointments, telephone consultations and the use of “catch up” periods led to very high levels of patient satisfaction.

Areas where the provider should make improvements:

• Implement a more effective system to record/demonstrate the actions taken in response to significant events and safety alerts.

• Review training needs to ensure all mandatory training is provided to staff and there is an effective system is put in place to manage and monitor this.

• Increase security arrangements for rooms containing equipment, cleaning products and fridges where immunisation/vaccinations are stored.

• Fridges used to store temperature sensitive medicines to be hard wired or otherwise clearly signed to ensure they are not exposed to inadvertent power loss.

• Review the documentation in recruitment files to ensure all relevant checks are made and documented in relation to the recruitment of staff.

• Introduce and embed a protocol for dealing with patient samples brought to reception.

• Review the policy relating to medicines management, particularly around signatories for delivery of controlled drugs and checking of nomad packs (medicines in sealed packs).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice