Excel Primary Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Skelmersdale Family Practice on 28 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Appropriate learning outcomes were identified following analysis of significant events, and staff demonstrated they were aware of these. However in some cases communication channels for cascading this learning were informal and lacked a robust documented audit trail of what information had been passed to whom.
• Risks to patients were assessed and mostly well managed.
• 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.
• 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. Complaints were handled in an open, transparent and timely manner.
• Patients said they did not always find it easy to make an appointment with a named GP, but the practice could demonstrate they had implemented a number of changes in order to address and rectify this.
• 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 when provided.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure documentation held around complaints provides a clear audit trail of the learning identifies and how this was shared within the organisation and with external stakeholders.

• Ensure changes made following the inspection around the monitoring of emergency medical equipment and chaperone procedures are fully embedded into practice.

• When a decision has been taken not to seek a DBS check for a member of staff, a risk assessment should be undertaken to provide clear documentation of the reasoning behind this decision. This applies to clinical staff where a recent DBS check from a previous employment has been deemed appropriate assurance that no risk is posed to patients. Update the practice’s recruitment policy to reflect this, and ensure the changes made around the retention of appropriate interview notes are fully embedded into the recruitment process.

• Ensure the protocol produced following the inspection detailing how communication channels for dissemination of learning were to be formalised is fully embedded into practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice