Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Jones and Robinson practice (also known as Withnell Health Centre) on 15 November 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events although there was a lack of documentation of discussions and no routine review of mitigating actions taken.

• Risks to patients were assessed and generally well managed. The building landlord’s representative had carried out premises risk assessments although the practice did not have sight of actions taken to address identified risks.

• 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.
• Processes were in place for handling repeat prescriptions which included the review of high risk medicines. However, the practice did not always check that patients who were taking medications that required monitoring, were being monitored appropriately when they were under the care of the hospital.
• 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. 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.
• Patient feedback on the practice service overall was consistently positive.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The practice was proactive in developing new ways to provide care and treatment. This was demonstrated in its award-winning nursing service to visit vulnerable patients in their own homes to assess their health and social care needs. We saw evidence of a reduction in patient unplanned admissions to hospital following the start of this service.

The areas where the provider should make improvement are:

• Review the practice significant event analysis procedure and recording form to allow for all actions taken as a result of analysis to be recorded and reviewed.

• Establish a dialogue to ensure that actions taken to address risks identified by the building risk assessment conducted by the landlord’s representative are carried out.

• Put systems in place to check that the appropriate monitoring is taking place for those patients under the care of the hospital when a repeat prescription is requested.

• Arrange for Patient Group Directions (PGDs) to be signed and authorised by all relevant staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice