Archived: The Tower of London Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tower of London Surgery on 10 January 2017. Overall the practice is rated as good.

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

• There were arrangements in place to safeguard children and vulnerable adults from abuse
• Risks to patients were assessed and well managed. Although the practice did not have its own portable defibrillator, several were available and accessible in the immediate vicinity and the practice had the support of The Tower of London’s trained first aid responders.
• The practice had a range of clinical equipment available to diagnose and treat patients and had recently put arrangements in place to have this equipment checked to ensure it was working properly.
• The practice was clean and had undertaken annual infection control audits but there were issues, for instance, chairs used by patients could not be wiped clean and arrangements to manage clinical waste did not reflect best practice.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• The GP assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to access the GP and there was continuity of care, with urgent appointments available the same day.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Put arrangements in place to mitigate risks associated with infection by providing chairs which are easily cleaned and a suitable container for clinical waste.
• Review arrangements to provide chaperones to determine whether these should include a process to carry out DBS checks on persons carrying out the role.
• Consider developing a process to compare patient outcomes at the practice with those of neighbouring practices and national averages until such time as the practice participates in the Quality Outcomes Framework (QOF) programme.
• Ensure there is an effective and accessible system for identifying, receiving, handling and responding to complaints from people using the service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice