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Archived: The Meads Medical Practice Good

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Reports


Inspection carried out on 29 March 2018

During an inspection to make sure that the improvements required had been made

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Meads Medical Practice on 5 October 2017. The overall rating for the practice was requires improvement. The full comprehensive report on the April 2017 inspection can be found by selecting the ‘all reports’ link for The Meads Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 29 March 2018. The purpose was to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 5 October 2017. A comprehensive action plan was provided by the practice in a timely manner, which detailed how action had been taken to make improvement. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

  • There was a system to help ensure that all medicines alerts from the Medicines & Healthcare products Regulatory Agency (MHRA) were actioned appropriately.
  • The practice was part of a commissioning pathway where some patients who were prescribed warfarin, an anticoagulant medicine, had their blood-clotting levels monitored outside of the practice. There was a system to check and record these levels prior to treatment being prescribed.

  • Higher than average areas of exception reporting for clinical outcomes had been addressed. The system to identify patients who were due to attend routine reviews had been reviewed. (Exception reporting is the removal of patients from calculations where, for example, the patients are unable to attend a review meeting).
  • There was a clear programme of quality reviews and clinical audits. Second cycles of audits had been carried out to demonstrate sustained improvements to patient outcomes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 5 October 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Meads Medical Practice on 5 October 2017. 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 for reporting and recording significant events.

  • The practice had systems to minimise risks to patient safety. However, there was no system to ensure that all medicines alerts from the Medicines & Healthcare products Regulatory Agency (MHRA) were actioned appropriately.

  • Data showed patient outcomes were good compared to the national average. However, exception reporting rates were high. (Exception reporting is the removal of patients from calculations where, for example, the patients are unable to attend a review meeting).
  • There was a programme of quality reviews and clinical audits. However, second cycles of audits had not yet been carried out to demonstrate sustained improvements to patient outcomes.
  • Staff were aware of current evidence-based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients we spoke with 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 clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The area where the provider must make improvements is:

Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. For example,

  • Implement a system that ensures all MHRA medicines alerts are actioned appropriately.

The areas where the provider should make improvements is:

  • Review the process for inviting patients to attend routine reviews and improve the system that records exception rates for clinical outcome measures.
  • Implement the plan to carry out repeat cycles of clinical audits to demonstrate improvements to patient outcomes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice