Letter from the Chief Inspector of General Practice

On 19 July 2016 we received allegations about Donald Wilde Medical Centre from an anonymous whistleblower. Not all of the allegations related to aspects of the Health and Social Care Act (Regulated Activities) Regulations 2014. The allegations relating to the Act were:

• There were no GP surgeries taking place some afternoons.

• There had been an increase in patient complaints due to the lack of surgeries available.

• Staff were being employed without the appropriate recruitment checks being carried out.

In response to the allegations being received we carried out an unannounced focussed inspection, just looking at the allegations we received.

We found that:

• In the week prior to the inspection GP surgeries had been held every morning and afternoon, Monday to Friday. The number of appointments provided was in line with recommended guidelines.

• Verbal complaints had been made about access to appointments but these had not been recorded. Previous complaints made to the practice had not been responded to appropriately. For example, written responses did not inform complainants of how they could escalate their complaint to the Parliamentary and Health Service Ombudsman (PHSO).

• No personnel information was held for some staff such as the practice nurse, advanced nurse practitioner, locum GPs and the two most recently recruited administrative staff.

The areas where the provider must made improvements are:

• The provider must ensure that all complaints received are investigated and responded to, with escalation procedures brought to the attention of complainants.

• The provider must ensure all policies and protocols are up to date so they can be assured all clinicians and staff follow the same procedure.

• The provider must ensure all appropriate employment checks are carried out prior to employing staff. They must ensure all clinicians have up to date registration with the appropriate professional body.

The practice was previously inspected on 10 March 2015. The practice was rated ‘good’ across all domains and ‘good’ overall. The ratings will not change following this inspection, although the provider will be expected to make the required improvements. However, the practice will receive a full comprehensive inspection in the future and ratings in all domains will be considered.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Donald Wilde Medical Centre on 10 March 2015. We found that the practice was rated as good overall.

Our key findings were as follows:

• The practice is rated as good for safe. Staff understood their responsibilities to raise concerns, and report incidents and near misses. Lessons were learned and communicated widely to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. There were enough staff to keep people safe.

• The practice is rated as good for effective. National Institute for Health and Care Excellence (NICE) guidance was referenced and used routinely. Patient’s needs were assessed and care was planned and delivered in line with current legislation. This included the promotion of good health. Staff had received training appropriate to their roles and further training needs were identified and planned. The practice had an effective appraisal system in place for all staff. Multidisciplinary working was evidenced.

• The practice is rated as good for caring. Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. Accessible information was provided to help patients understand the care available to them. We also saw that staff treated patients with kindness and respect ensuring confidentiality was maintained.

• The practice is rated as good for responsive. The practice reviewed the needs of their local population and engaged with the NHS Local Area Team (LAT) and Clinical Commissioning Group (CCG) to secure service improvements where these were identified. Patients reported good access to the practice and the GPs and continuity of care, with urgent appointments available the same day. The practice had good facilities and was well equipped to treat patients and meet their needs. There was an accessible complaints system with evidence demonstrating that the practice responded quickly to issues raised.

• The practice is rated as good for well-led. The practice had a clear vision and strategy to deliver this. There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity. There were systems in place to monitor and improve quality and identify risk. The practice proactively sought feedback from staff and patients and this had been acted upon. Staff had received inductions, regular appraisals and attended staff meetings. The practice had a developing patient participation group (PPG).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection September 2017 – Requires improvement).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

The practice was inspected on 29 September 2017 and was rated requires improvement. Requirement notices were issued in relation to regulatory breaches of Regulation 16 (Receiving and acting on complaints), Regulation 17 (Good governance) and Regulation 19 (Fit and proper persons employed). This report can be viewed by selecting the ‘all reports’ link for Donald Wilde Medical Centre on our website at www.cqc.org.uk.

This announced comprehensive inspection at Donald Wilde Medical Centre was carried out on 18 May 2018. This was a full inspection that also looked in detail at these areas where improvement was required following the September 2017 inspection.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice