28/02/2020 and 3/3/2020
During an inspection looking at part of the service
We carried out an announced focused inspection at Now Healthcare Group on 28 February 2020. We also attended the service on the 2 March 2020 to collect further evidence.
The practice was previously inspected on 8 October 2019. Following the inspection, the practice was rated requires improvement overall (inadequate in safe, requires improvement in effective and well-led, and good in caring and responsive). We issued a warning notice for breaches of Regulation 17 (Good Governance) and Regulation 12 (Safe care and treatment). This focused inspection was to follow up on the warning notices.
We did not review the ratings awarded to this practice at this inspection.
We based our judgement of the quality of care at this service on a combination of:
• what we found when we inspected
• information from our ongoing monitoring of data about
services and
• information from the provider, patients, the public and
other organisations.
We found the provider had made some improvements in providing safe services but further improvements were still needed. In particular the provider had removed some high-risk medicines from the formulary, but we still found examples of poor prescribing and relevant blood checks not being undertaken before issuing certain medicines. After the inspection the provider informed us that a further 355 medicines had been removed from the formulary.
We found that the provider had made some improvements for providing effective services. In particular the provider had added a functionality to their clinical system to enable a GP to tick a box when a patient gave consent for the service to share information with their NHS GP. However, we found examples of medicines liable to abuse being prescribed without gaining consent to share information with the patient’s NHS GP, which may have increased the risk of harm if the patient was getting the same medicine from their NHS GP.
We found the provider had made some improvements in providing well-led services in relation to good governance and had implemented systems and process in response to the findings of our previous inspection.
The practice will be re-inspected within six months of the original inspection report being published and this will be a full comprehensive inspection.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care