Archived: Abbey Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr MF Haq's Practice on 12 May 2015. Overall the practice is rated as inadequate.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example we identified concerns with the arrangements for managing vaccines.
• Staff were not clear about reporting incidents, near misses and concerns; and there was limited evidence of learning and communication with staff.
• Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
• Formal governance arrangements were limited and we noted confusion regarding roles and responsibilities.
• There was evidence of division and a lack of communication between clinical and non-clinical staff which hindered progress on improving patient outcomes.

The areas where the provider must make improvements are:

• Introduce protocols to ensure that vaccines are safely managed and stored; and that staff are aware of their responsibilities.
• Undertake a risk assessment of the practice’s decision to carry a limited range of emergency drugs; and introduce a system of checking expiry dates of emergency drugs.
• Take action to address identified concerns with infection prevention and control practice (such as an absence of annual infection prevention and control audits; a lack of cleaning schedules for ear syringe, nebuliser and spirometer equipment; and worn waiting area seating which posed a cross infection risk).
• Ensure there are systems in place so that learning from significant events is communicated to support improvement.
• Ensure clinical audits are undertaken in the practice, including completed clinical audit or quality improvement cycles.
• Introduce a written protocol for instances where GPs are on annual leave (or otherwise unavailable) for dealing with patient blood test results.
• Ensure that recruitment arrangements include all necessary pre-employment checks.

• Ensure that appropriately signed Patient Group Directions (PGDs) are on file for practice nurses where this is required.

In addition the provider should:

• Undertake a risk assessment of its decision not to undertake portable appliance testing of non clinical electrical equipment.
• Introduce a safeguarding vulnerable adult’s policy.
• Review the practice patient confidentiality systems and procedures.
• Ensure that all non clinical staff receive annual appraisals.

I am placing this practice in special measures. Practices placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The practice will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice