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Inspection carried out on 27, 28, 29 June 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

Mount Gould Medical Centre is operated by Access Health Care, a social enterprise organisation owned by Exeter based Devon Doctors. The practice comprises of three separate medical centres located within three separate areas of the city of Plymouth, Devon. The patient population group of 10,058 was divided as 2795 patients at Mount Gould, 4231 patients at Ernesettle branch and 3032 at the Trelawny branch. (Collectively referred to as sites)

The clinical governance, complaints and human resources management are conducted at the Devon Doctors headquarters in Exeter. There were no GP partners at the practices.

We carried out an announced comprehensive inspection at Mount Gould Medical Centre on 27, 28 and 29 June 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 in place for reporting and recording significant events.
  • The practice had clearly defined and embedded systems to minimise risks to patient safety. For example, the practice management teams were open about the shortfalls identified since Access Healthcare had taken over the leadership. Action plans were in place for these issues and timescales had often been met. We saw evidence that action plans demonstrated assessment of risk and priority.

  • 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.
  • Patients said they 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.
  • Not all patients we spoke with said they found it easy to get through on the telephone or make an appointment with a GP and added that there was not always continuity of care, but said urgent appointments were available the same day. This had been identified by the management who were in the process of introducing a new telephone system, employing additional staff (clinical pharmacist), and improving ways of how patients could access and cancel routine appointments.
  • All three practices had good facilities and were well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. Staff said Access Healthcare were a ‘structured’ and ‘supportive’ employer and added that the practices were good places to work. Staff said they had received detailed inductions, supervision, and support and had access to sufficient training and education.
  • The practice proactively sought feedback from staff and patients, which it acted on. For example, changes in appointment processes, introduction of additional car park spaces and drinking water dispensers in waiting areas.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

  • Ensure systems are in place to demonstrate that patients, in addition to an apology, are informed on any delay in response to complaints.

  • Ensure systems are in place to ensure the overview and monitoring of clinical roles are consistent and completed across all three sites, and managed by staff with appropriate skills

  • Ensure systems continue to ensure the coding (Recording and identification of specific screening tests, conditions and illnesses) are consistently recorded over all three sites to ensure the patient record is accurate and clearly show past and present medical conditions.

  • Ensure patient access to GP appointments is monitored following the introduction of new telephone system.

  • Continue with the monitoring and audit of the quality of the patient summary record

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice