Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Jericho Health Centre - Kearley on 16 August 2016. Overall the practice is rated as good. Improvements are required to ensure the service is providing safe services.

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

• There was a system in place for reporting and recording significant events. Reviews of complaints, incidents and other learning events were thorough.
• Risks to patients were mostly assessed and well managed. However, some risks were not fully managed specifically in relation to monitoring of fridge temperatures and storage of liquid nitrogen.
• Staff assessed patients’ ongoing needs and delivered care in line with current evidence based guidance.
• National data suggested patients received appropriate care for long term conditions.
• The system for reviewing patients on repeat medicines identified patients who required a review, but the practice was in the process of ensuring higher achievement of up to date medicine reviews was achieved.
• Staff were trained in order to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. 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 and routine 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.
• There was a strong ethos of continuous learning.

Areas the provide must make improvements are:

• Ensure risks related to cold chain storage of medicines, emergency medicines and liquid nitrogen are managed appropriately.

Areas the provide should make improvements are:

• Continue to improve the monitoring of patients on repeat prescriptions and ensure that patient reviews of their long term conditions are maximised via minimising exceptions.
• Review lower than average uptake of specific child vaccines.
• Consider feedback regarding consultations with GPs where feedback from the national survey is consistently below local averages.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at Observatory Medical Practice on 16 August 2016 found breaches of regulations relating to the safe care and treatment. The overall rating for the practice was good. However, they were rated requires improvement in the safe domain. The full comprehensive report from the August 2016 inspection can be found by selecting the ‘all reports’ link for Observatory Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused desktop inspection (we have not visited the practice but requested information to be sent to us) carried out on in March 2017. It was conducted 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. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the practice had made improvements since our last inspection. The information requested in March 2017 identified that the practice was meeting the regulation that had previously been breached. We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services. In addition the practice made improvements to its services where we suggested this could improve services for patients.

Our key findings were as follows:

• Improvements had been made in the storage of medicines and procedures for when vaccines were potentially compromised.
• Liquid nitrogen storage had been reviewed and improvements made.
• Child immunisations had been reviewed, training provided to staff and a review of children who had not attended undertaken.
• A change to medicine review processes had been implemented to improve uptake within required timescales.
• The practice undertook its own survey to identify whether patient feedback was accurately portrayed in the national survey and this found positive feedback on the areas which had been of concern.

In addition to the areas where we told the provider they must make improvements, there were also actions where we suggested the provider should make improvements. In response they undertook the following actions.

• A review of child immunisations had been undertaken and action to improve uptake.
• The process for medicine reviews had been changed to increase uptake for timely reviews.
• The practice undertook their own survey in October 2016 to focus on areas where the national survey had identified less positive feedback from patients when compared to local and national averages. The practice’s own survey of 453 patients showed patient feedback was significantly better in the practices own survey in these specific areas.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice