Archived: Oswald Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced follow up inspection Oswald Medical Practice on 10 November 2016.

Following a comprehensive inspection on 12 April 2016 the practice was issued with two requirement notices due to breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. This was in relation to shortfalls in systems for risk management and health and safety and the management of medicines. The practice was rated as Requires Improvement. An action plan was submitted with agreed timescales, identifying the action the practice would take.

We undertook a focused inspection to follow up the action taken by the practice in these specific areas. We found the practice had completed the action plan and was now meeting the required regulations.

Overall the practice is now 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 an improved system in place for reporting and recording significant events and there was evidence that learning was shared across the practice.

• Risks to patients were assessed and were effectively managed.

• The management of complaints had been reviewed. Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• The practice had good facilities and was well equipped to treat patients and meet their needs. All equipment was now serviced and maintained as required. Portable appliance testing had been completed.

• The management of medicines had been improved, with additional security measures implemented for the distribution and storage of prescriptions.

• The authorisations to administer medicines via patient group and patient specific directions had been reviewed. Systems had been implemented to better manage and to reduce risks

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Oswald Medical Centre on 12 April 2016. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, the level of detail within associated records maintained by the practice was insufficient to demonstrate communication and learning from incidents was effective.
• There was evidence of risk management activity within the practice. However, risk management activity was not comprehensively completed. For example, the practice had not appropriately assessed or managed risks related to fire safety and security.
• Data showed patient outcomes were low compared to the locality and nationally. The practice was taking action to address performance issues through the recruitment of nursing staff and completion of audit activity.
• The majority of patients said they were treated with compassion, dignity and respect.
• Urgent appointments were usually available on the day they were requested.
• The practice had a number of policies and procedures to govern activity. However, we found that policies and procedures were not always followed or implemented as intended. For example, the practice did not complete regular checks of water temperature within the practice in accordance with practice policy to mitigate the risk of legionella bacteria. In addition, the practice had not applied processes and systems for the management of medicines consistently or effectively.

• The practice had proactively sought feedback from patients and had arrangements in place for a patient participation group. However, the group was not active at the time of our visit.

The areas where the provider must make improvements are:

• Ensure the arrangements and actions for identifying, recording, mitigating and managing risks to patient safety, building maintenance and security are comprehensive and complete.

• Ensure the systems and processes for the management of medicines, vaccines and associated items are adequate and fully embedded.

• Ensure staff responsible for the administration of vaccines and medicines are appropriately authorised.

• Ensure blank computer prescription forms are controlled and secured when distributed within the practice.

• Check electrical equipment in accordance with practice policy to ensure the equipment is safe to use.

In addition the provider should:

• Ensure records of concerns, complaints and incidents are sufficiently detailed to support effective communication and learning.

• Implement practice policies and procedures and take action to ensure practice staff follow them.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice