9 June 2017
During an inspection looking at part of the service
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection of Heald Green Health Centre 2 on 30 November 2016. At the inspection in November the overall rating for the practice was good, although the key question Safe was rated requires improvement. This was specifically in relation to the management of medicines that required patients to receive regular health care checks and the systems to ensure medicines were changed and checked appropriately when requested by a secondary care provider such as a hospital consultant. We also identified some areas where the practice could improve other aspects of the service they provided. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Heald Green Health Centre 2 on our website at www.cqc.org.uk.
This inspection was an announced focused inspection carried out on 9 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection on 30 November 2016. This report covers our findings in relation to those requirements and also the additional improvements made by the practice since our last inspection.
The practice is now rated as good for providing safe services, and overall the practice is rated as good.
Our key findings were as follows:
- Since the previous inspection the practice had employed a pharmacist to assist the GPs with the management of medicines. This included identifying and monitoring those patients who required regular health checks and those patients discharged from hospital with changes to their prescribed medicines.
- A protocol had been established so that prescriptions for repeat requests for medicines such as for example Warfarin (blood thinning medicine) were only issued if an up to date blood result (INR)was available.
- The systems to ensure the practice received Warfarin blood results in a timely manner had been reviewed and improved communication links had been established with a local hospital that carried out the INR blood testing.
- Patients prescribed other high risk medicines such as disease-modifying anti-rheumatic drugs (DMARDs) were monitored with monthly searches on patient records to ensure the appropriate checks such as blood tests had been undertaken. In addition a screen message had been added to each patient’s electronic record so that staff could easily identify those patients requiring these checks.
- The practice management team had reviewed their procedure in relation to monitoring and responding to pathology tests results. The practice ensured that all pathology test results were allocated out to those GPs on duty each day. This ensured that these were checked within the appropriate timescale.
- The practice had made improvements to the practice’s record systems. For example a safety alert log was now established and accessible to staff. This provided a brief record of actions taken and hyperlinks to the relevant documents.
- The practice also maintained a log of significant events with a brief description of the incident and log of action taken all staff. A log of all meetings was also maintained.
- The practice had undergone some staff changes since the last inspection and this had enabled the practice to review its staffing establishment and the activities undertaken by the different staff teams. This had resulted in a streamlining of the nursing team and appointments scheduling and a change in how GP appointments were scheduled.
- As part of the local Clinical Commissioning Group (CCG) initiative the practice has had a new telephone system installed however the additional benefits from the system had yet to be ‘switched’ on by the CCG.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice