Bramham Medical Centre

We carried out an announced comprehensive inspection at Bramham Medical Centre on 15 February 2018. The overall rating for the practice was good; with a rating of requires improvement for providing safe services. The full comprehensive report for the February 2018 inspection can be found by selecting the ‘all reports’ link for Bramham Medical Centre on our website at .

In addition to the areas for improvement identified under the key question for providing safe services, at the inspection on 15 February 2018 we also said the practice should consider the following areas:

• Continue to review and improve the function of the patient participation group.
• Review exception reporting rates for the Quality and Outcomes Framework to assure themselves that patients are being excepted in line with the latest guidance.

This inspection was an announced focused inspection carried out on 10 July 2018 to confirm that the practice had made the required improvements identified at the previous inspection on 15 February 2018. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

At this inspection we found:

• The practice had clear systems and processes in place to monitor usage of both printed and blank prescriptions.
• The practice had reviewed the process for recording significant events and incidents. We saw minutes from practice meetings in which significant events had been discussed and learning had been shared with staff.
• We saw that fabric curtains in all of the treatment rooms had been replaced with disposable ones. The practice had a system in place to ensure these were replaced every six months.
• The practice had sourced additional training for the infection prevention and control (IPC) lead. Due to demand and staff availability, the first available course was March 2019. We saw evidence that the infection prevention and control lead had been booked to attend this course.
• The practice had introduced a standard operating procedure to address areas of high exception reporting rates for the Quality and Outcomes Framework.
• The practice had hosted two patient participation group meetings and was taking steps to increase interest from patients.

We saw one area where the provider should make improvements:

• The provider should ensure that the IPC lead attends, completes and implements learning from the additional IPC training that has been booked to support them in their role.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

This practice is rated as Good overall. (Previous inspection October 2015 - Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Bramham Medical Centre on 15 February 2018. We carried out this inspection as part of our inspection programme.

At this inspection we found:

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Results from the national GP patient survey were consistently good and patient feedback we received on the day largely supported this.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice was involved in a number of local and national initiatives. For example; the locality scheme pilot for a visiting GP service over the winter period and the NHS 111 pilot scheme allowing patients to be remotely allocated to a GP appointment during hours.
• The practice was aware of challenges facing smaller providers and were exploring options to overcome these.

The areas where the provider should make improvements are:

• Continue to embed the new system and keep records of prescription numbers in order to monitor usage of both printed and blank prescriptions.
• Implement fully the significant event policy and supporting reporting form in order to maintain an adequate record of learning from all significant events and incidents.
• Arrange for the Infection Prevention and Control lead to receive additional training to support them in the role.
• Continue to review and improve the function of the patient participation group.
• Review exception reporting rates for the Quality and Outcomes Framework to assure themselves that patients are being excepted in line with the latest guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice