Archived: Eastville Medical Practice

Letter from the Chief Inspector of General Practice

On Wednesday 3 December 2014 we carried out an announced comprehensive inspection at Eastville Medical Practice. During the inspection we gathered information from a variety of sources. For example, we spoke with patients, members of the patient participation group, interviewed staff of all levels and checked the systems and processes in place.

Overall the practice is rated as good. Specifically, we found the practice to be good for providing well-led, effective, caring, safe and responsive services. They were also good for providing services for patients who circumstances may make them vulnerable, families, children and young patients, older patients, working age and retired patients, patients with long term conditions and patients experiencing poor mental health.

Our key findings 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.
• 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 found it difficult to contact the practice either by phone or visiting the practice. It was often found patients would be queuing outside the practice for appointments or were on hold waiting for a significant time on the phone to make an appointment. The practice had tried to improve this for patients but had a number of challenges making this difficult to achieve.
• 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.
• The practice had good communication with other services to ensure patients received the best care possible.

We saw several areas of outstanding practice including:

• The practice supports a local drug project and a support worker attended the practice once a week to provide support to patients who need help and advice. One of the GPs led on drug and alcohol misuse. We were told the service had been very beneficial to patients. The agencies work closely together and were able to share information about patient’s welfare regularly with each other.

• The practice had a high number of patients who were from Somalia. The practice had a health link worker who spoke Somali visiting the practice once a week to support these patients who may need assistance, such as with interpreting English when visiting the GP.

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

The provider should:

• Ensure all fire safety recommendations were addressed promptly and clearly recorded to ensure risks to patient safety were reduced if there was a fire.
• Ensure nurse practitioners receive regular formal clinical supervision from a GP for their independent prescribing role
• Ensure the recruitment policy reflects current legislation, such as detailing whether health and social care relation references were required depending on the employee’s previous experience and proof of identification for new employees.

• Continually review staffing levels and ensure patients were seen and spoken with promptly when visiting and phoning the practice.
• Ensure staff monitoring refrigerator temperatures where vaccines were kept are aware of current practice protocols in line with this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice