Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Good Health PMS on 15 July 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were 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.
• Patients said they found it difficult to make an appointment as it was particularly difficult to get through on the phone. Patients told us the easiest way to make an appointment was to attend the practice in person.
• The practice had good 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.

We saw one area of outstanding practice:

• The practice was seeking ways to reach out to hard to reach, seldom served patients, particularly their house bound patients. They had started a pilot of ‘prophylactic’ visits to some of their housebound patients who rarely accessed the service. They hoped to formalise and provide the service to all housebound patients in the future.

However there were areas of practice where the provider needs to make improvements.

The provider should

• Ensure out of range fridge temperatures are properly explained and actions taken recorded in response to these events
• Ensure there is a system for the management of prescription pads so they are properly accounted for
• Ensure suitable arrangements are in place for seeking consent prior to birth control implant procedures
• Actively seek to involve patients in developing and improving the service through the development of a patient participation group
• Ensure improvements are made to the telephone system to allow patients to make contact with the practice as required

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We did not speak with people using the service due to the nature of the essential standard we inspected.

We found the provider had systems in place to assess and monitor the quality of service provision

We visited both the main practice surgery at Erith Health Centre and the Barnehurst surgery as part of this inspection. We spoke to people and staff at both locations. Most people we spoke with told us they were very happy with the treatment they received when visiting the practice. One person told us "the GP I usually see is really good". They told us that when they'd had concerns the GP had arranged a referral to a specialist for them "just to be safe" which they found very reassuring. Another person told us "everyone here is always friendly and the surgery is always clean."

We found that people were treated with dignity and respect when visiting the practice and that they were involved in making decisions about their treatment. People's treatment was planned and delivered in such a way as to ensure their safety and welfare. The provider had taken appropriate steps to protect people from the risk of abuse. Suitable employment checks had mostly been made on staff prior to their starting working. We also found that the provider acted upon feedback from people using the service and that appropriate changes were implemented as a result of learning from any incidents. However, we also found that the provider did not always have suitable systems in place to ensure that risks to people's safety and welfare were monitored.