This practice is rated as Good overall. (Previous rating 06/2018 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

We carried out an announced comprehensive inspection at Byfield Medical Centre on 14 June 2018. The overall rating for the practice was good with requires improvement for providing safe services. The full comprehensive report on the June 2018 inspection can be found by selecting the ‘all reports’ link for Byfield Medical Centre on our website at .

This inspection was an announced focused inspection carried out on 14 January 2019 to confirm that the practice had made the recommended improvements that we identified in our previous inspection on 14 June 2018. This report covers our findings in relation to those improvements made since our last inspection.

Overall the practice is rated as good.

At this inspection we found:

• The practice had completed risk assessments and taken the recommended actions in relation to fire safety, health and safety, premises and security.
• Reception staff had received training and guidance so they could identify the ‘red-flag’ symptoms of sepsis.
• Standard Operating Procedures in the dispensary had been reviewed so all prescriptions were signed by a GP before they were dispensed.
• The practice had discontinued the medicines delivery service provided by volunteers.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Byfield Medical Centre on 29 March 2016. Overall the practice is rated as good although the safe domain requires improvement.

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

• There was an open and transparent approach to safety and whilst there was a system in place for reporting and recording significant events it was not sufficiently robust and embedded to capture all events and allow reflection and assess the effectiveness of actions.
• Risks to patients were in the main 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 although some areas of mandatory training were outstanding for some staff.
• Patients reported consistently high levels of satisfaction regarding their treatment and care from the practice. They said they were always treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• 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 adequate facilities and was well equipped to treat patients and meet their needs.
• 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 and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Review the significant events process to ensure that staff are aware to raise all significant events, ensure they are all investigated formally, specifically the dispensary and include a means of revisiting the actions to determine their effectiveness.
• Ensure all staff undertake mandatory training in safeguarding, cardio pulmonary resuscitation and infection control.
• Ensure appraisals are completed for all staff annually including those which remain outstanding.

The areas where the provider should make improvement are:

• The practice should amend the systems for dealing with safety alerts to demonstrate what actions have been taken.
• The practice should amend the business continuity plan to include contact telephone numbers of staff and utility companies.
• The practice should ensure that all GPs gain written consent for surgical procedures.
• The practice should amend the complaints leaflet to include information regarding what to do if patients are not satisfied with the outcome of the investigation of a complaint.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice