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Inspection Summary


Overall summary & rating

Updated 27 November 2017

Letter from the Chief Inspector of General Practice

We undertook an announced comprehensive inspection of MSF Medical Services on 8 May 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. Breaches of Regulation 12 (Safe care and treatment) of the Health & Social Care Act 2008 were found. The full comprehensive report following the inspection on 8 May 2017 can be found by selecting the ‘all reports’ link for MSF Medical Services on our website at www.cqc.org.uk.

This inspection was a follow up desk based focused inspection of MSF Medical Services carried out on 10 October 2017 to confirm that the service had implemented their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. This report covers our findings in relation to those requirements.

The service is now providing safe, effective and well led care in accordance with the relevant regulations.

Our key findings were:

  • Following the previous inspection, the service had introduced quality assurance processes to ensure that medicines were prescribed in line with national guidance and internal policy.

  • The service had reviewed their system for the storage of patient safety and medicine alerts and made changes to ensure that they maintained a clear audit trail.

  • The service had re-assessed the risks associated with the medicines they had available to prescribe, and had made changes to mitigate the risks identified to ensure that they were prescribing safely.
  • The service had put processes in place to flag when staff training and registrations were due for renewal.
  • The service had introduced a programme of team meetings which were attended by all GPs.
  • The service had revised the contract of employment for all of their GPs to include the requirement that GPs should provide evidence that they have discussed their role in online prescribing with their appraiser as part of their NHS appraisal.
  • The provider had considered the risks associated with patients being able to revise the answers given in the prescribing questionnaire, and as a result they had amended their system to alert GPs where this had happened.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Updated 27 November 2017

At our previous inspection on 8 May 2017 we found that the service was not compliant with

section 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of their arrangements for processing medicines alerts, and a warning notice was issued.

When we re-inspected in October 2017 we found that the service had addressed this issue and was now compliant with regulations in respect of this. The service is now providing safe care.

  • The service had developed their process for reviewing medicines alerts, and had updated their policy, to stipulate that copies of all medicines alerts, including those which were not relevant to the service, should be saved to their system in order to ensure they had a complete audit trail.

Effective

Updated 27 November 2017

At our previous inspection on 8 May 2017 we found that the service was not compliant with

section 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of their arrangements for monitoring prescribing decisions, and a warning notice was issued.

When we re-inspected in October 2017 we found that the service had addressed this issue and was now compliant with regulations in respect of this. The service is now providing effective care.

  • Following the initial inspection, the service reviewed their prescribing and updated their risk assessment and mitigation plan for the medicines available. The service also introduced a process of periodically reviewing their prescribing of the medicines they had available to ensure that all prescribers were adhering to internal and national guidance, and had made improvements to the prescribing process as a result of these reviews.

Caring

Updated 27 November 2017

Responsive

Updated 27 November 2017

Well-led

Updated 27 November 2017

At our previous inspection on 8 May 2017, we found that that service was not providing well-led services because they lacked the governance processes to provide safe and effective care.

These arrangements had significantly improved when we undertook a follow up inspection on 10 October 2017. The service is now providing well led care.

  • Following the initial inspection the service had reviewed their prescribing processes and put comprehensive arrangements in place to improve safety and effectiveness, such as reviewing their prescribing risk assessment and mitigation plan, and enhancing their programme of clinical audit to ensure compliance to internal and national prescribing guidance. The service had also developed their process for reviewing medicines alerts to ensure that this included a complete audit trail.