Archived: Middle Chare Medical Group

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gardiner Crescent Surgery on 27 April 2016. Overall the practice is rated as good. Gardiner Crescent Surgery is part of one large provider (Middle Chare Medical Group) who have four locations. All patients can be seen at any of the locations; however, most attend one of two for continuity of their care. 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 a system in place for reporting and recording significant events. However, we found that some of the systems to keep patients safe had not been implemented effectively.

• The standard operating procedures did not cover all processes for example there were no procedures for the safe dispensing of high risk medicines. Arrangements were not in place to ensure that vaccines and other medicines in the refrigerators were stored at the correct temperatures and appropriate records were not maintained. Governance systems and processes were not adequate in the dispensary to ensure that patients were safe from harm.

• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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 leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

The practice worked in collaboration with the Ear Nose and Throat department from the local hospital and provided a room for consultations. This collaborative way of working had led to improved knowledge in this area and had reduced practice referrals to secondary care, providing care closer to home.

The practice provided a dermoscopy service to its patients and this had led to a reduction in referrals to secondary care.

The area where the provider must make improvement is:

Ensure there are effective arrangements in place to ensure that vaccines and medicines stored in the refrigerators are stored at the correct temperatures and appropriate records are maintained.

Governance systems and process are to be developed further to monitor and assess the whole service in relation to risk and improvement, including training of staff in the dispensary, quality assurance of internal processes, checking of emergency medicines and the safe storage of vaccines.

The areas where the provider should make improvement are:

To monitor that all staff are able to access policies and procedures.

To monitor clinical audit as a continuous process to demonstrate quality improvement.

To monitor recording of significant events in the dispensary and detail action taken and lessons learned.

To monitor prescription forms after they have been received into the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice