Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The New Queen Street Surgery on 28 June 2016. The overall rating for the practice was good, and requires improvement in relation to providing safe services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for The New Queen Street Surgery on our website at www.cqc.org.uk.

This inspection was an announced desk-based review carried out on 23 May 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 28 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection. Overall the practice is rated as good, which includes providing safe services.

Our key findings were as follows:

• The practice had created and appointed to a new dispenser post for 27.5 hours per week to improve dispensing services.
• There was an effective system in place for reporting, recording, investigating, reviewing and learning from near misses in the dispensary.
• Dispensing standard operating procedures for dispensing medicines, including controlled drugs (CDs) and dispensary stock, had been reviewed and updated. (Controlled Drugs are medicines that require extra checks and special storage requirements because of their potential for misuse).
• Improvements had been made to ensure the dispensing process for medicines, including CDs was safe.
• The practice had established a system for checking that medicines in the dispensary were in date. We reviewed documented records that these checks had been undertaken. These included checks of the controlled drugs and that the controlled drug register had been completed appropriately.
• The practice had undertaken a planned fire drill in November 2016 and this had been documented. Future fire drills had been scheduled according to their fire safety policy.
• The arrangements for the safe storage of clinical supplies had been reviewed. These were now kept in a locked storage room, to minimise the risk of unauthorised access.
• The practice had increased the number of annual health checks undertaken for people with learning disabilities from 24% during 2014 to 2015 to 73% from 2016 to 2017. A dedicated administrator was now responsible for coordinating and booking the reviews. These were scheduled on the patient’s month of birth and a recall system was set up to monitor uptake. The practice had developed links with a learning disability link nurse who supported this work, which included the use of easy read information for inviting patients, informing them about the health check and a pre health check questionnaire.
• The practice had established systems to monitor the practice appointment system and had made changes to increase effectiveness. The practice now offered a broader range of appointment times throughout the day and week and had increased the number of telephone appointments available for patients. Patients also had access to GP and nurse appointments from 6.30pm to 8pm Monday to Friday and from 9am to 5pm Saturday and Sunday at a central location in Peterborough. Patients from the practice could be booked an appointment through the practice computer system.

At our previous inspection on 28 June 2016, we rated the practice as requires improvement for providing safe services as systems and processes relating to the dispensing of medicine, including Controlled Drugs, were not always followed. (Controlled Drugs are medicines that require extra checks and special storage requirements because of their potential for misuse). At this inspection we found that improvements had been made. Consequently, the practice is rated as good for providing safe services.

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 The New Queen Street Surgery on 28 June 2016. The overall rating for the practice was good, and requires improvement in relation to providing safe services. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for The New Queen Street Surgery on our website at www.cqc.org.uk.

This inspection was an announced desk-based review carried out on 23 May 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 28 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection. Overall the practice is rated as good, which includes providing safe services.

Our key findings were as follows:

• The practice had created and appointed to a new dispenser post for 27.5 hours per week to improve dispensing services.
• There was an effective system in place for reporting, recording, investigating, reviewing and learning from near misses in the dispensary.
• Dispensing standard operating procedures for dispensing medicines, including controlled drugs (CDs) and dispensary stock, had been reviewed and updated. (Controlled Drugs are medicines that require extra checks and special storage requirements because of their potential for misuse).
• Improvements had been made to ensure the dispensing process for medicines, including CDs was safe.
• The practice had established a system for checking that medicines in the dispensary were in date. We reviewed documented records that these checks had been undertaken. These included checks of the controlled drugs and that the controlled drug register had been completed appropriately.
• The practice had undertaken a planned fire drill in November 2016 and this had been documented. Future fire drills had been scheduled according to their fire safety policy.
• The arrangements for the safe storage of clinical supplies had been reviewed. These were now kept in a locked storage room, to minimise the risk of unauthorised access.
• The practice had increased the number of annual health checks undertaken for people with learning disabilities from 24% during 2014 to 2015 to 73% from 2016 to 2017. A dedicated administrator was now responsible for coordinating and booking the reviews. These were scheduled on the patient’s month of birth and a recall system was set up to monitor uptake. The practice had developed links with a learning disability link nurse who supported this work, which included the use of easy read information for inviting patients, informing them about the health check and a pre health check questionnaire.
• The practice had established systems to monitor the practice appointment system and had made changes to increase effectiveness. The practice now offered a broader range of appointment times throughout the day and week and had increased the number of telephone appointments available for patients. Patients also had access to GP and nurse appointments from 6.30pm to 8pm Monday to Friday and from 9am to 5pm Saturday and Sunday at a central location in Peterborough. Patients from the practice could be booked an appointment through the practice computer system.

At our previous inspection on 28 June 2016, we rated the practice as requires improvement for providing safe services as systems and processes relating to the dispensing of medicine, including Controlled Drugs, were not always followed. (Controlled Drugs are medicines that require extra checks and special storage requirements because of their potential for misuse). At this inspection we found that improvements had been made. Consequently, the practice is rated as good for providing safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Before patients were offered any care, treatment or immunisations clinical staff ensured that a valid, implied, verbal or written consent was obtained. One patient we spoke with said, "They (GPs) always explain everything to me so that I understand the options available to me. I am given time to consider my options and I don't feel rushed."

The majority of patients we spoke with told us that they had a positive experience of using the New Queen Street Surgery. Urgent appointments booked on the day of the appointment were available but this service had a high demand. All patients we spoke with confirmed to us that they were always treated with dignity and their choices and wishes were respected.

The provision of infection prevention and control training, environmental audits, cleaning programmes and schedules meant that patients, staff and other visitors were effectively protected from acquiring a health care associated infection. Patients we spoke with told us that the surgery was, "Always very clean."

Records of complaints we reviewed demonstrated to us that, where possible, complaints had been resolved to the satisfaction of complainants. One patient said, "I don't know how to complain but I would speak with the practice manager." The same patient told us that they had never had cause to complain.