Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingswinford Medical Practice on 12 January 2017. 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 care and respect. We saw that staff were friendly and helpful and treated patients with kindness and respect.

• Staff spoken with demonstrated a commitment to providing a high quality service to patients. Audits were used to monitor quality and to make improvements. The practice was proactive in identifying, managing and learning from significant events, incidents, complaints and patient survey responses.

• Patients could access appointments and services in a way and at a time that suited them.

There were longer appointments available for patients when needed. The practice offered urgent access appointments for children, as well as those with serious medical conditions.

• Clinical staff carried out home visits for older patients and patients who would benefit from these. The practice nurses also visited families from a local travelling community to ensure that children were up to date with their immunisations.

• Staff, teams and services were committed to working collaboratively. We saw evidence that multi-disciplinary team meetings took place on a monthly basis with regular representation from other health and social care services including local health visitors and school nurses.

• Some of the practices protocols reflected best practice and were well embedded. For example, the practice utilised a comprehensive system to review their patients’ attendances at the local Accident and Emergency department, use of the ambulance service and emergency hospital admissions. The practice maximised use of this system to aid monitoring and recall systems and to reduce prescription wastage.

• However, during our inspection we noted that governance arrangements were not always effective across specific systems and processes when managing complaints. We also noted that in areas documentation was unclear with regards to patient specific directions (PSDs); for the health care assistant to administer specific vaccinations and to demonstrate that review and authorisation was made by the prescribing GP.

• Staff assured us that they would amend their PSD system to incorporate adequate record keeping and we received further assurance from the practice shortly after our inspection to demonstrate that a more effective system was being utilised.

• Members of the management team indicated that some coding work was required across specific areas to accurately reflect the care plans in place across their mental health and dementia registers. However during our inspection we saw evidence to support that adequate care plans were in place and there was an effective recall system in place for patients needing medication and general health reviews.

• We observed the premises to be visibly clean and tidy. Notices were displayed to advise patients that a chaperone service was available if required however we noted that no male members of staff provided a chaperone service and the clinical team was mostly female, with one male GP registrar in post during our inspection.

The areas where the provider should make improvements are:

• Continue to identify carers in order to provide further support where needed.

• Ensure that policies associated with complaint management reflect guidelines and are embedded in practice.

• Continue to ensure that records and processes are well governed to reflect patient specific direction (PSD) requirements including review, specification and authorisation.

• Consider the need of a male chaperone so that male patients have the option of a male or female chaperone.

• Maximise the functionality of the computer system to consistently code all patient groups and produce accurate performance data.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice