Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Clift Surgery on 18 February 2015. Overall the practice is rated as good.
Specifically, we found the practice to be good for providing well-led, effective, caring and responsive services. It was also good for providing services to older people, people with long term conditions, families, children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health. It required improvement for providing safe services.
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 well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that 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 was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
However there were areas of practice where the provider needs to make improvements.
Action the provider MUST take to improve:
- Ensure all prescriptions were reviewed and signed by a GP before they were given to the patient.
- Ensure that fridge temperatures were recorded and that historical records were maintained.
- Implement better key security for controlled drugs and prescription forms – at the time of our inspection these were accessible by all staff entering the dispensary.
- Implement prescription security – serial numbers were not recorded.
- Ensure that standard operating procedures (SOP) for dealing with medicines were in place. Some of the SOPs, especially for controlled drugs were not complete as they needed to reflect the procedures at the practice.
Action the provider SHOULD take to improve:
- Learning from errors – we could not see consistent evidence of learning from errors, trend analysis etc. Some errors had repeated despite a significant event.
- Medicines Alerts – received by administration staff, but dispensary should have ownership of the process.
- Emergency medicines and “Doctors’ Bags”: There should be a rationale for selecting drugs, this was not clear, for example; no drugs were carried for cardiac emergencies.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice