Letter from the Chief Inspector of General Practice

We carried out an announced follow up inspection at Brundall Medical Partnership on 21 June 2016. Overall the practice is rated as good. This was to follow up on actions we asked the provider to take after our announced comprehensive inspection on 16 November 2015. During the inspection in November 2015, we identified:

• There was scope to improve the monitoring and auditing of fridge temperatures.
• There was scope to improve the arrangements for the security of medicines stored in the dispensary to ensure they are only accessible to authorised staff.
• Staff who undertake the checking of medicines in the dispensary were not appropriately trained, qualified and competent to undertake this role.
• There was scope to improve the protocols in place for the handling, analysis, audit and review of dispensing errors including discussion at dispensing team meetings. In addition there was scope to improve the systems in place to record near-miss dispensing errors to identify trends and ensure these are monitored and actions taken where necessary.
• There was scope to improve the protocols in place for the monitoring and auditing of the risks involved in receiving telephone repeat prescription requests, ensuring processes for producing repeat prescriptions are undertaken away from avoidable distractions to prevent errors.
• Cascading, sharing and learning from concerns and complaints to all staff required further improvement.
• Patients waiting for their appointments in some areas of the practice could not be clearly seen by reception staff to ensure patients whose health might deteriorate are overlooked by staff.
• There was scope to improve clinical audits undertaken in the practice, including completed clinical audit or quality improvement cycles.
• Audit trails to demonstrate which MHRA (Medicines & Healthcare products Regulatory Agency) alerts and safety updates needed to be improved.

The practice manager provided us with evidence which showed the practice had put systems in place to improve these systems.

However there were areas of practice where the provider needs to make further improvements: Continue to risk assess and monitor patients waiting for their appointments in all areas of the practice to ensure patients whose health might deteriorate are not overlooked by staff

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 follow up inspection at Brundall Medical Partnership on 21 June 2016. Overall the practice is rated as good. This was to follow up on actions we asked the provider to take after our announced comprehensive inspection on 16 November 2015. During the inspection in November 2015, we identified:

• There was scope to improve the monitoring and auditing of fridge temperatures.
• There was scope to improve the arrangements for the security of medicines stored in the dispensary to ensure they are only accessible to authorised staff.
• Staff who undertake the checking of medicines in the dispensary were not appropriately trained, qualified and competent to undertake this role.
• There was scope to improve the protocols in place for the handling, analysis, audit and review of dispensing errors including discussion at dispensing team meetings. In addition there was scope to improve the systems in place to record near-miss dispensing errors to identify trends and ensure these are monitored and actions taken where necessary.
• There was scope to improve the protocols in place for the monitoring and auditing of the risks involved in receiving telephone repeat prescription requests, ensuring processes for producing repeat prescriptions are undertaken away from avoidable distractions to prevent errors.
• Cascading, sharing and learning from concerns and complaints to all staff required further improvement.
• Patients waiting for their appointments in some areas of the practice could not be clearly seen by reception staff to ensure patients whose health might deteriorate are overlooked by staff.
• There was scope to improve clinical audits undertaken in the practice, including completed clinical audit or quality improvement cycles.
• Audit trails to demonstrate which MHRA (Medicines & Healthcare products Regulatory Agency) alerts and safety updates needed to be improved.

The practice manager provided us with evidence which showed the practice had put systems in place to improve these systems.

However there were areas of practice where the provider needs to make further improvements: Continue to risk assess and monitor patients waiting for their appointments in all areas of the practice to ensure patients whose health might deteriorate are not overlooked by staff

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Everyone we spoke with who was either waiting to be seen or had been seen had something positive to say about their visit and the practice generally. One person told us, "There's been lots of change over the years and all for the good." They also went on to say that the practice had not lost "the personal touch" over the years.

The practice offered pre-booked appointments, on-line booking of appointments and ‘on the day’ appointments. These would be with either a designated doctor or the duty doctor to help patients who needed urgent consultations. The doctors also carried out a telephone triage system where appropriate. Appointments with the nurse practitioner were also offered.

The practice took all relevant steps to maintain patients' privacy and dignity and we noted that the practice had a Patient Participation Group (PPG) which acted on behalf of patients.

One person we spoke with told us, "I'm fully satisfied and couldn't wish for a better doctors' surgery". They went on to tell us that they would have said straight away if things were not right.

We observed staff treating people with respect and being helpful and considerate.

The practice building was easy to access with ample parking. There was a toilet accessible to people with disabilities on the ground floor and baby changing facilities were provided also.