Archived: Bexley Group Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bexley Group Practice on 25 August 2015. Overall the practice is rated as requires improvement.

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:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Most information about safety was recorded, monitored, appropriately reviewed and addressed.
• Some risks to patients and staff were assessed and well managed, with the exception of those relating to lone working and responding to emergencies.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Most staff had received training appropriate to their roles, however not all staff had received mandatory training.

• Data showed patient outcomes were average or above for the locality. Clinical audits had been carried out, with evidence that audits were driving improvement in performance to improve patient outcomes.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP or nurse and that there was continuity of care, with urgent appointments available the same day.
• The practice had adequate facilities and was well equipped to treat patients and meet their needs; however not all areas of the practice were wheelchair accessible.
• 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, although the patient participation group was less actively involved at the Nuxley Road location.

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

Importantly the provider must

• Review the arrangements for the practice to be able to appropriately respond to emergencies; including access to a defibrillator.
• Ensure that staff are adequately trained and updated in fire safety, infection control and mandatory safeguarding children’s training.
• Ensure that the risks of lone working have been thoroughly assessed, with mitigating actions put in place.
• Ensure there are clear and effective systems in place to govern activity at the Nuxley Road practice, to include assessing, managing and responding to risks, safety alerts, incidents and complaints; and adequate monitoring and recording of staff information including recruitment and training.
• Ensure that recruitment arrangements include all necessary employment checks for staff.

Importantly the provider should

• Ensure that prescription pads are tracked and monitored in the practice.
• Ensure that translation services are advertised in the practice.
• Ensure that the practice environment is suitable for wheelchair users and those with mobility difficulties.
• Ensure that systems to promote confidentiality and privacy at the practice are reviewed.
• Ensure that the Patient Participation Group (PPG) is actively involved in improving services at the Nuxley Road practice site.
• Ensure that all clinicians have a clear understanding of the consent and decision-making requirements of the Mental Capacity Act 2005.
• Ensure all staff have easy access to policies, procedures and guidance to carry out their role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice