Archived: Benfield Valley Healthcare Hub

Letter from the Chief Inspector of General Practice

The practice was rated good overall and is now rated good for providing safe services.

We carried out an announced comprehensive inspection of this practice on 23 June 2016. A breach of legal requirements was found during that inspection within the safe domain. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a focused inspection on 9 March 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 23 June 2016 we found the following areas where the practice must improve:

• Implement systems for assessing, monitoring and acting on risks in relation to the health and safety of patients, staff and visitors.
• Take action to address identified concerns with infection prevention and control.
• Improve the security of blank prescription stationery.

Our previous report also highlighted the following areas where the practice should improve:

• Continue to take action in order to address areas where lower levels of patient satisfaction have been identified.
• Ensure that plans to ensure all staff have an annual appraisal are successfully implemented.
• Keep higher than average exception reporting rates for the quality and outcomes framework under review and ensure action is taken to reduce rates where clinically appropriate.(Exception reporting is the removal of patients from Quality and Outcomes Framework calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).
• Build on the work undertaken so far to identify carers within the practice in order to increase the number of carers known to the practice and help ensure they receive appropriate support.
• Ensure that risk assessments accurately identify staff who are likely to be left alone with patients and that appropriate recruitment checks are undertaken

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 9 March 2017 we found:

• Systems were now in place for monitoring and acting on risks in relation to the health and safety of patients, staff and visitors.
• Concerns identified at the last inspection in relation to infection prevention and control had been addressed.
• Arrangements were now in place for the tracking of blank prescription stationery.

We also found in relation to the areas where the practice should improve:

• Results from the national GP Survey published in July 2016 showed that patient satisfaction had improved in some areas. For example during this inspection we found that 80% of patients who responded were able to get an appointment or speak to someone last time they tried compared to 63% from the results published in January 2016. However, patient satisfaction was still lower than average in a number of key areas including patients being able to see a preferred GP, GPs involving patients in decisions about their care, treating them with care and concern and explaining tests and treatments. Patient satisfaction with their overall experience of the practice and the number of patients who would recommend the practice was also lower than average. The practice should therefore continue to take action in order to address areas where lower levels of patient satisfaction have been identified.
• We saw that plans to ensure all staff had an annual appraisal had been implemented.
• Exception reporting rates had reduced in a number of areas, for example in mental health. However, exception reporting rates for asthma had increased to 30% and were significantly above the national average of 7% and the clinical commissioning group average of 10%. The practice should therefore continue to review exception reporting rates for the quality and outcomes framework and ensure action is taken to reduce rates where clinically appropriate.
• The practice had built on its work to identify the number of carers on its list and ensure they were signposted to the various avenues of support. For example, the NHS health check template now included a hyperlink to the local carers support information so that this could be printed off for patients. The practice had identified a further 50 carers since our last inspection. The practice had updated its risk assessment to ensure that it accurately identified staff that were likely to be left alone with patients. We saw that appropriate recruitment checks had been undertaken as a result.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice