Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Belle Vale Medical Practice on 28 April 2017. Overall the practice is rated as good.

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

• Belle Vale Medical Practice is situated in a health centre shared with other community clinics. There is disabled access, a hearing loop and translation facilities.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Patients we spoke with and Care Quality Commission (CQC) comment cards reviewed indicated that patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment but not necessarily with a named GP of their choice. 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 the requirements of the duty of candour.

We saw an area of outstanding practice:

The practice engaged well with the patient participation group (PPG) and actively sought engagement within local community groups and their patients. For example,

• The practice hosted carer forum meetings for carers from their practice and other practices within the locality.
• The practice manger and chair of the PPG had attended a local school to gain the views of teenagers as to what medical services they required. Teenagers involved had helped produce a newsletter for the practice to highlight areas of importance to this population group.
• One of the GPs attended a primary school to give educational sessions regarding healthy lifestyles.

• The practice designed their own information leaflets and used humorous poetry to convey messages. For example, they designed a leaflet intended for the over 75s with useful contact numbers, information about obesity and information about cancer screening.
• Over the past 12 months the practice had run a monthly search of all patients over 85 years who had not been seen within the past year and reviewed their records. If there had been no contact with any health care professional they attempted to contact the patient by telephone, if unsuccessful they sent a letter and if that failed a visit to the patient was made.

The areas where the provider should make improvement are:

• Ensure the process of managing uncollected prescriptions follows the practice protocol, as outlined in the repeat prescribing policy.
• Monitor the prescribing of individual prescribers.
• Review any significant events to identify any trends to prevent reoccurrence.
• Carry out regular infection control audits.
• Consider whether the practice needs additional oxygen for use in medical emergencies. In addition, have appropriate safety signage for the room where oxygen is stored; and add information as to where oxygen is stored to the fire map at the entrance of the practice for fire officer’s information.
• The practice should consider adding further advice to staff as to what to do in other types of emergency other than power /IT failure within the business contingency plan.
• Have a system to review dates for when safety checks such as electrical and for fire safety equipment are due.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice