Archived: Whitestone Surgery

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 2 quality statements from this key question. We found current measures and responses were insufficient to ensure patient safety and the appropriate management of patients with long-term conditions.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

During the assessment interview on 11 July 2024 we discussed the management of patients diagnosed with long term conditions. At this assessment the provider acknowledged the concerns but did not provide evidence to demonstrate what plans would be put in place to mitigate the risks.

At the inspection in January 2024 our clinical searches identified concerns related to potential missed diagnosis of patients with conditions such as diabetes. This placed patients at risk of not receiving appropriate management and follow-up of their long-term condition and condition deteriorating leading to irreversible complications.

Information reviewed on the 15 July 2024 lacked detail to assure us that the provider would have effective plans in place to mitigate the risk of these concerns reoccurring. The action plan the provider shared with us mentioned that the practice nurse would be undertaking a review of care plans and regular reviews would be carried out but no timescale was provided as to when this would be completed. The plan also indicated that the practice manager would monitor potential missed diagnoses of patients with long term conditions. These measures were not sufficient to ensure patient safety and proper management of long-term conditions as it meant staff with no clinical qualifications would be tasked with this responsibility.

There was no evidence of the training to be offered to staff and no evidence of whether an audit was planned to determine if other patients had been reviewed appropriately.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

During the interview with the provider on 11 July 2024 we discussed the management of patients test results, reports and other health related correspondence received by the practice. The provider told us that the plan would be to assign the management of clinically related workflow to a named clinician and practice nurse. We were not assured of this plan as the provider did not provide any evidence of how this would be implemented and monitored to ensure patients were followed up in a timely and appropriate manner.

During our inspection in January 2024 we identified that there were 237 laboratory reports that were unmatched or unfiled to patients records dating back to 30/12/2020, 51 of these showed abnormal results. This placed patients at risk of being unaware of their abnormal results and with no action being taken by the practice to further investigate and treat them.

At this assessment the provider told us that a review of workflow at the practice would be carried out. A clinician would be assigned to any backlog of laboratory reports. However, there was no supporting evidence that a policy or procedure had been written to implement the changes. There was no evidence of training to support administrative staff in taking on tasks related to checking results, filing and coding had been provided. There were plans proposed for the practice nurse to have responsibility for checking and filing all results including abnormal results which would then be passed to the GP for further review. However, there was no evidence provided on the training the nurse would receive to undertake this task. This did not provide assurance that staff would have the necessary knowledge and skills needed to undertake tasks safely and effectively.

There was no evidence of audits having been completed to monitor and review clinical outcomes.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.