Greengate Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Greengate Medical Centre on 14 March 2016. Overall the practice is rated as requires improvement.

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

• The practice list was at or beyond the capacity of the premises and the waiting room was cramped with patients often queuing outside the door. However, the partners had taken steps to extend the premises.
• Emergency equipment and cleaning schedules were not in place but the practice was clean.
• The practice used information such as patient safety alerts, best practice clinical guidance and completed audits to improve quality and manage risk.

• The practice had a number of policies and procedures to govern activity but there were some gaps in important areas such as infection control, medicines management and elements of staff safety training.
• The practice did not have effective arrangements for receiving and acting on complaints.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had role specific skills, knowledge and experience to deliver effective care and treatment.
• Data from the National GP Patient Survey showed patients rated the practice as comparable for most areas of care except patients’ access and practice nurses care.
• Patients said they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• There was continuity of care, with urgent appointments available the same day and the practice had facilities to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider must make improvements are:

• Implement effective arrangements for receiving and acting on complaints.
• Ensure appropriate safety training for all staff in accordance with their role including fire safety, infection control and safeguarding.
• Introduce a system for the production of Patient Specific Directions for Health Care Assistants to administer injectable medicines after specific training when a doctor or nurse are on the premises.
• Implement a system to ensure reference and DBS checks for non-clinical staff or an appropriate DBS risk assessment. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

The areas where the provider should make improvement are:

• Monitor and improve QOF performance for people with mental health problems.
• Implement effective systems to check and maintain emergency medicines and equipment, premises and equipment cleaning and infection control.
• Review systems for managing significant events including the procedure.
• Ensure delivery of premises improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice