This practice is rated as good overall. (previous inspection 22 May 2018  rated Good overall, requires improvement for safe domain)

The key question reviewed is rated as:

Are services safe? – Good

We carried out an announced inspection at PDS Medical Planned Care  on 22 May 2018 as part of our inspection programme. At this inspection the service was rated as Good overall, with the safe domain rated as requires improvement. This was due to the lack of readily available  emergency equipment, whilst undertaking clinical sessions and inconsistency in guidance available for staff in relation to the management of sepsis. Also patient medication reviews were not consistently undertaken.

We undertook a follow up inspection on 9 November 2018 to ascertain if improvements had been made.

At this inspection we found:

• The provision of equipment for clinical sessions had been reviewed
• Emergency equipment now included a defibrillator, oxygen and face masks
• Guidance had been reviewed and implemented for the management of sepsis
• The system for undertaking patient medication reviews had been reviewed and improved.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as good overall. The service has not been inspected previously.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced inspection at PDS Medical Planned Care (also known as the Zero Tolerance Practice or Special Allocation Scheme) on 22 May 2018 as part of our inspection programme.

At this inspection we found:

• The service had clear systems to manage risk so that the impact of safety incidents were minimised or less likely to happen. When incidents did happen, the practice investigated them and discussed them as a team. However outcomes of these discussions and lessons learnt were not clearly recorded.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines wherever possible.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients did not always find the appointment system easy to use and some patients would not engage with the service.
• There was a strong focus on continuous learning and improvement at all levels of the organisation in order to continue to develop this new service.

The area where the provider must make an improvement is:

• Ensure care and treatment is provided in a safe way to patients

The areas where the provider should make improvements are:

• Outcomes of investigations and complaints and the lessons learnt should be clearly recorded and actions reviewed.
• Records of managing patient safety alerts should be maintained and audited.
• The service should consider establishing a planned programme of audits.
• Staff should consider adding summaries of previous patient care to their records to improve the understanding for clinical staff.
• Staff should consider the use of a care plan system to support patients with long term conditions or complex problems and implement a regular review of medication.
• Implement a more comprehensive assurance system from the clinical locations used in respect of  infection control requirements
• The service should implement a system to obtain patient feedback

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice