Archived: Parkside Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkside Medical Practice on 18 October 2016. Overall, the practice is rated as requires improvement.

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. However, reviews and investigations were not thorough enough. Some completed incident recording forms did not demonstrate that people were told about any actions to improve processes to prevent the same thing happening again.
• Some risks to patients were assessed and well managed. However, systems for managing patient safety alerts, recording the monitoring of high risk medicines; checking clinicians’ registrations and indemnity cover, nurse’s professional memberships and risk assessing staff who had not receive appropriate immunity status checks were not well managed. Following the inspection the practice provided documentations to evidence where they had reviewed the practice systems.
• 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 in most areas. Following the inspection the practice provided documents to demonstrate that some additional training had been completed
• Staff received yearly appraisals; however, the practice did not provide documentation to evidence how staff competencies had been reviewed during and after role specific inductions.
• Although the practice held clinical meetings, documents viewed did not demonstrate that they were occurring regularly and evidence of actions required or completed as a result of meeting discussions were limited.
• During the inspection staff were able to demonstrate where the practice had worked with other health care professionals. Although performance related to the uptake of childhood vaccinations for under two year olds were below CCG and national averages staff explained actions taken to support the increase of uptake.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. During the inspection staff were seen to be treating patients with kindness and respect, and maintained patient and information confidentiality.
• Information about in-house and community based services was available. The practice held a variety of well-attended health awareness events and information evenings to raise awareness of health conditions and the verity of support services available.
• Details of 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 named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There were areas where the governance structure and systems was not effectively operated. For example, the management and implementation of systems, policies and processes did not ensure that they were always well established or effectively operated.
• There was a 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.

The areas where the provider must make improvement are:

• The practice must establish and operate effective systems and processes. For example, the practice must operate effective systems for managing incidents, recording the completion of medicine reviews, sharing safety alerts, maintaining accurate patient records and ensuring adequate indemnity cover are in place for clinicians.

• Establish an effective system for monitoring and ensuring staff have received identified training to enable them to fulfil the requirements’ of their role. Implement an effective system to monitor and review staff competencies during and after induction.

The areas where the provider should make improvement are:

• Ensure an effective employee immunisation programme is in place for staff who handles clinical specimens or carry out an appropriate risk assessment to mitigate risks.

• Establish an effective system for checking clinicians’ registrations, and nurses’ professional memberships.

• Continue to explore ways of improving the uptake of childhood immunisations.

• The practice should ensure that business continuity plans are well embedded and staff are aware of the content and where to access the plan.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice