Drs Adey and Dancy

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Adey and Dancy on 8 November 2016.

Overall the practice is rated as good.

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

• There were systems in place to reduce risks to patient safety, for example, the practice ensured there were sufficient numbers of staff to meet the needs of patients. Improvements were needed to ensure safety checks at the premises took place, significant events were more effectively managed and to the processes for deciding on the provision of emergency equipment at the branch practices.

• Staff understood their responsibilities to raise concerns and report incidents and near misses. Staff spoken with knew how to identify and report safeguarding concerns.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff told us they felt well supported. Overall, they received an annual appraisal and had access to the training they needed for their roles.

• Patients were positive about the care and treatment they received from the practice. The National Patient Survey July 2016 showed that patients’ responses about whether they were treated with respect, compassion and involved in decisions about their care and treatment were comparable to local and national averages.

• Services were planned and delivered to take into account the needs of different patient groups.

• The National GP Patient Survey results showed that patient’s satisfaction with access to care and treatment was above or in line with local and national averages.

• Information about how to complain was available. There was a system in place to manage complaints.

• There were systems in place to monitor and improve quality and identify risk.

However there were areas of practice where the provider must make improvements:

• The provider must ensure the premises are safely maintained.

• The provider must ensure that a documented risk assessment is put in place to determine if there is a need to provide emergency equipment at the branch practices.

• The provider must ensure there is an effective system for recording the actions taken and learning points in relation to significant events.

The areas where the provider should make improvements are:

• Put in place a system to record the action taken following receipt of patient safety alerts.

• Action plans with timescales should be developed to address the issues identified in the recent infection control audits of the branch practices.

• Monitor and review the effectiveness of the system recently introduced to monitor two week rule referrals to ensure patients receive the tests they are referred for.

• Monitor and review the effectiveness of the recently introduced protocol around the security of prescriptions.

• Undertake a risk assessment to determine which emergency medications should be available at the main and branch practices.

• A risk assessment of the storage of written patient records should be undertaken to ensure these are securely stored at all times.

• Staff recruitment records should contain evidence of identity and of information having been gathered about any physical or mental conditions which were relevant (after reasonable adjustments) to the role the person was being employed to undertake.
• Maintain a central record of all clinical training undertaken by staff to assist with monitoring their training needs.
• The salaried GP should have an in-house appraisal in addition to the external appraisal process.
• A record should be made of meetings to demonstrate that important information such as actions from audits and significant events has been shared.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice