We carried out an announced comprehensive inspection at Green Lane Medical Centre on 7 December 2018 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• 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. However, further improvements could be made by increasing the scope of incidents and near misses reflected and documented by the practice.
• 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. There was a positive variation in results from the National GP patient survey data for how well GPs listened to patients and treated patients with care and concern compared to other practices.
• We received several comments about difficulties in getting through to the practice and being able to make an appointment. Since our last inspection, the practice had made several improvements for patient access including, increasing its GP and nursing team, installing more telephone lines and refurbishing patient access and waiting areas with the input of the patient participation group and staff.
• Information about services and how to complain was available but further information about how the practice would respond was only given verbally. The standard of documented responses and information for verbal and written complaints was inconsistent.
• The practice sought patient and staff views about improvements that could be made to the service, including having a well- established patient participation group and acted on feedback.
• Staff worked well together as a team and all felt valued and supported to carry out their roles.
• There was a clear governance structure and policies and protocols made available to all staff. Further improvements were needed in terms of ensuring some protocols and oversight systems were managed appropriately.
• There was a strong focus on continuous learning and improvement at all levels of the practice.
• The practice complied with the Duty of Candour.

Whilst we found no breaches of regulations, the provider should:

• Implement a system to monitor staff vaccinations to ensure staff remain fully up to date with their immunisations.
• Implement a system to ensure that all nursing staff receive required additional training.
• Revise the uncollected prescriptions policy and ensure all staff are aware of the protocols in place.
• Increase the scope of incidents and near misses reflected and documented by the practice.
• Review the standards of complaint audit documentation; and have a written leaflet explaining to patients what will happen when they complain to the practice and who to make their complaint to if they did not wish to complain to the practice directly.
• Review how staff are responding to patients wanting to make an appointment to improve patient satisfaction levels around making appointments.
• Implement a monitoring system for the use of blank prescriptions within the building and store these more securely.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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 Green Lane Medical Centre on 23 November 2015.

Overall the practice is rated good.

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

• The practice was clean and was about to have extensive alterations to improve disabled access and reception and waiting area facilities.
• Patients experiences of making appointments overall including being able to call the practice, was lower than local and national satisfaction averages. However there were plans in place to install a new telephone system.

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding.

• Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service, including having a patient participation group (PPG) and acted on feedback.

• Staff worked well together as a team and all felt supported to carry out their roles.

There were improvements the provider should consider:-

• Carry out an analysis of significant events and complaints over time to identify any trends.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice