Archived: Droylsden Medical Practice

Letter from the Chief Inspector of General Practice

Droylsden Medical Practice was inspected on 21 April 2015. This was a comprehensive inspection. This means we reviewed the provider in relation to the five key questions leading to a rating on each on a four point rating scale. Overall we rated the practice as good and specifically in respect of being safe, effective, caring, responsive and well-led.

Our key findings were as follows:

The practice has a system in place for reporting, recording and monitoring significant events. Significant incidents and events are used as an opportunity for learning and improving the safety of patients, staff and other visitors to the practice.

The practice has systems in place to ensure best practice is followed. This is to ensure that people’s care, treatment and support achieves good outcomes and is based on the best available evidence.

Information we received from patients reflected that practice staff interact with them in a positive and empathetic way. They told us that they were treated with respect, in a polite manner and as an individual. Patients expressed their satisfaction in respect of the quality of the care and treatment provided at the practice. However patients consistently expressed concern in respect about difficulties in getting through to the practice on the telephone in the mornings and securing an appointment to see a clinician. The provider had reviewed these issues and taken action to address them.

However there were areas of practice where the provider should make improvements.

Importantly the provider should:

Clinical audits were instigated from within the practice or as part of the practice’s engagement with local audits. We saw two recent examples of these relating to 2 week referrals and prescribing. Both were quite recent and consequently there was no evidence of re-audit. However it was evident there were plans in place for this to be done. The documentation relating to the reasons for the audit and the summary action plan was sparse and lacking in detail. The provider should ensure the documentation relating to clinical audits is improved.

Whilst networks of peer support and communication between individual staff and the wider multidisciplinary team were good formal clinical and practice meetings had been infrequent until January 2015. These meetings provide important opportunities for all practice staff to come together to share and discuss ideas, improve practice and learn as a team from incidents. The provider should ensure the action they have taken to hold such meetings on a monthly basis is sustained.

A system was in place for hospital discharge letters and specimen results to be reviewed by a GP who would initiate the appropriate action in response. When a new diagnosis has been made this was coded (read coding system) in the summary of patient’s medical records. However we were informed that there was a considerable backlog in completing this coding (and new summaries). To ensure the summary in patient’s medical records are as contemporaneous as possible this backlog should be addressed as soon as possible.

At the time of our visit the two regular GPs were seeing the more complex cases, managing all medication reviews and repeat prescriptions and the clinical administrative work generally. We were informed the regular GPs were providing 43 hours per week in GP time and locums 32 hours per week. The potential risk of this balance on the role of the regular GPs should be regularly reviewed by the provider to ensure the requirements on the salaried GPs remain manageable.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice