Letter from the Chief Inspector of General Practice

We carried out an announced inspection of this practice on 16 October 2014. Breaches of legal requirements were found. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

• Regulation 10 HSCA 2008 (Regulated Activities) Regulations 2010 Assessing and monitoring the quality of service providers (which corresponds to Regulation 17 of the HSCA 2008 (Regulated Activities) Regulations 2014);
• Regulation 12 HSCA 2008 (Regulated Activities) Regulations 2010 Cleanliness and infection control (which corresponds to Regulation 12 (2) (h) of the HSCA 2008 (Regulated Activities) Regulations 2014);
• Regulation 13 HSCA 2008 (Regulated Activities) Regulations 2010 Management of medicines (which corresponds to Regulation 12 (f) and (g) of the HSCA 2008 (Regulated Activities) Regulations 2014);
• Regulation 16 HSCA 2008 (Regulated Activities) Regulations 2010 Safety, availability and suitability of equipment (which corresponds to Regulation 15 of the HSCA 2008 (Regulated Activities) Regulations 2014).

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Widdrington Medical Practitioners on our website at www.cqc.org.uk.

Our key findings were as follows:

• The practice had made significant progress and had addressed all of the issues identified during the previous inspection.
• A new and highly effective governance framework had been implemented.
• The culture within the practice was inclusive and all staff had felt supported during the period of reflection and improvement.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Widdrington Medical Practitioners on 16 October 2014.                                                                                  

We rated the practice overall as inadequate.

Our key findings were as follows:

• most people told us they were happy with the care they received. They said they were treated with respect and were generally positive about staff. 
• practice staff worked well together and with other healthcare staff, for example district nurses and midwives.
• patients could get appointments easily, although this was not always with the doctor of their choice.

However, there were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• take action to ensure its medicines are handled appropriately and management arrangements are in line with national guidance and recommendations; and
• review its systems for assessing and monitoring the quality of the service provision and take steps to ensure risks are managed appropriately.
• put appropriate arrangements in place to ensure medical equipment is regularly checked and medical consumables are in date.
• take action to address infection prevention and control to ensure that they comply with the ‘Code of Practice for health and social care on the prevention and control of infection and related guidance’.

In addition, the provider should:

• consider whether the deployment of staff and staffing levels are appropriate. 
• review its arrangements for staff training, including safeguarding adults and chaperoning.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as good overall. (Previous inspection – 9 July 2015 – rating – good).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Widdrington Medical Practitioners on 24 April 2018, as part of our planned inspection programme.

At this inspection we found:

• 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.
• Staff had the skills, knowledge and experience to carry out their roles.
• The practice routinely reviewed the effectiveness and appropriateness of the care and treatment they provided. Staff ensured that care and treatment was delivered in line with evidence- based guidelines.
• The practice organised and delivered services to meet patients’ needs. They took account of patient needs and preferences.
• Overall, patients found the appointment system easy to use and reported that they were able to access care and treatment when they needed it.
• There was a very strong focus on continuous learning and improvement at all levels of the organisation.
• Staff involved patients in decisions about their care and treatment and treated them with compassion, kindness, dignity and respect.
• The practice had a clear vision to deliver high quality care and promote good outcomes for patients.
• Governance processes and systems for business planning, risk management, performance and quality improvement operated effectively

We also saw an area of outstanding practice:

• One of the GP partners had devised a clinical system safety algorithm to help ensure that, following any type of contact with a patient, the practice’s IT system automatically identified any outstanding clinical tasks or overdue reviews. The algorithm provided staff with access to an appropriately worded letter which they were then able to issue to the patient. In addition, they had also devised other algorithms to carry out automatic searches to check whether patients prescribed high-risk medicines had received appropriate monitoring and if patients had any overdue blood tests that needed to be carried out. This had helped the practice to achieve their very good Quality and Outcomes Framework (QOF) results.