Archived: Park Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park Medical Centre on 11 April 2017. The overall rating for the practice was good, with requires improvement for providing safe services. The full comprehensive report on the April 2017 inspection can be found by selecting the ‘all reports’ link for Park Medical Centre on our website at www.cqc.org.uk.

We undertook a focused inspection on 20 June 2017 to check they had followed their action plan and to confirm they now met legal requirements in relation to the breach identified in our previous inspection on 11 April 2017. This report only covers our findings in relation to those requirements.

Overall the practice is now rated as good.

Our key findings from this inspection were as follows:

• Extensive work had been undertaken to ensure that there was an effective recall system in place to support patients who were prescribed medicines that required specific monitoring.
• The practice had implemented a new process for monitoring the expiry dates of medicines held in clinical fridges.
• A clear policy had been written to ensure that GPs authorised the destruction of uncollected prescriptions. A system had been instigated to ensure that an audit trail was in place and that vulnerable patients were contacted to arrange collection.
• The practice had developed an effective process for tracking blank prescription stationery held on the premises.

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 Park Medical Centre on 11 April 2017. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and generally well managed. The practice had a medicine review system in place to support patients who take medicines that require monitoring. However, data demonstrated this system was not always effective. Following the inspection the practice immediately sent us a comprehensive analysis of the issue identified and a supporting action plan to demonstrate how improvements would be embedded into practice.
• The nursing team had developed a checking schedule for medicines held in a clinical fridge, however this was not always effective as we found an expired medicine that had not been identifed and removed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Feedback from patients about their care was consistently positive. Patients said they were treated with compassion, dignity and respect and that they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in July 2016 showed that patients rated the practice in line with others for all aspects of care.
• Information about services and how to complain was available and easy to understand. 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 GP and that there was continuity of care. A walk-in minor illness clinic enabled patients to be seen on the day without the need for an appointment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff we spoke with reported that there was a clear leadership structure and that they felt well supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The Patient Participation Group was active and worked collaboratively with the practice to host health education events focused on different patient groups, such as those with diabetes.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The practice had recognised the growing need for integrated care services in the local area and had employed their own in-house primary care community matron. The community matron worked to ensure that housebound patients and patients unable to attend the surgery could be appropriately assessed and receive support in the community. Data showed that the practice’s rate of emergency admissions, referral rates and accident and emergency presentations were lower than the local commissioning group averages. For example, data from the clinical commission group showed that the rate of emergency admissions following the introduction of the community matron maintained a flat trend below the local average, despite a rise in practice list size. The primary care community matron contacted all patients after their discharge from hospital to address any concerns and assess if the patient needed GP or nurse involvement at that time. Medicine reviews were arranged if necessary to ensure patients had a good understanding of any newly prescribed medicines, and to check for contraindications.

The areas where the provider must make improvement are:

• Ensure the recall system for medicine reviews for patients who are prescribed medicines that require specific monitoring is effective and that actions taken in response to the concerns identified on the day of our inspection are embedded into practice.
• Ensure that systems and processes are in place, embedded and monitored to ensure that medicines available for patients are within their expiry date.

Furthermore, the practice should make the following improvements:

• Introduce effective processes and clinical oversight for monitoring uncollected prescriptions being held in the reception area before they are destroyed.
• Develop a process for tracking blank prescription stationery held on the premises.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice