Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Elizabeth House Medical Practice on 10 November 2016. Overall the practice is rated as good.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed with the exception of recording risk assessments, checking of the emergency medicines and security of blank prescription forms.
• 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 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:

We received very positive feedback about the way the practice supported palliative care patients, their families and the multi-disciplinary teams from patients and the local hospice team and the district nursing team. The partners provide a direct contact number for patients and their families when they are in the end stages of life, so that they could provide continuity of care for these patients and they could be treated by GPs that they know at this difficult time rather than strangers. The partners provided this service overnight and during the weekend in addition to normal surgery times. The practice also used a patient information letter they had produced, which gave practical information such as how to register the death and contained information about bereavement support services.

The areas where the provider must make improvement are:

• Ensure that risk assessments are recorded and easily accessible to all GPs and staff.
• Ensure that blank prescription forms are stored securely at all times.

Ensure that emergency medicines are always in date and there are systems and processes in place to monitor and that sharps safes are not in use for longer than directed.

The areas where the provider should make improvement are:

• Review the adult safeguarding policy and the use of safeguarding codes in the clinical system.
• Review and improve the process of how learning from significant events is shared to ensure all staff groups are included.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Elizabeth House Medical Practice on 10 November 2016. The overall rating for the practice was good although the practice was rated as requires improvement for providing safe services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Elizabeth House Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 20 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 10 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key findings were as follows:

• The practice had reviewed their adult safeguarding policy following the last inspection. The policy contained local contact details and outlined the different types of abuse that staff should be aware of.
• Sharing of learning from significant events and incidents was a regular agenda item at team meetings for non-clinical staff.
• The practice had reviewed their sharps protocol to reflect best practice guidance for the use of sharps bins.
• The arrangements for ensuring security of blank prescription forms had been reviewed and a new protocol implemented.
• The practice had commenced a log of health and safety related risk assessments which were updated regularly to ensure actions were completed.
• The emergency medicines list had been updated to include expiry dates to ensure medicines were fit for use in the event of an emergency occurring. However, the interval between checks of the emergency medicines was after some of the medicines were due to expire.

Areas where the practice should make improvements:

• Ensure the interval for checks of the emergency medicines is reviewed and reflects best practice guidelines.

We have changed the rating to reflect the findings for the provision of safe services. The practice is now rated as good for providing safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice