Docklands Medical Centre

We previously carried out an announced comprehensive inspection of Docklands Medical Centre on 6 February 2019. At the inspection, we rated the practice as good overall, but as requires improvement for providing safe services because:

• We found incidents of unsafe prescribing of some high risk medicines and there were no prescribing protocols in place for some high risk medicines.

The full report of the February 2019 comprehensive inspection can be found by selecting the ‘all reports’ link for Docklands Medical Centre on our website at www.cqc.org.uk.

We carried out an announced focused inspection of Docklands Medical Centre on 9 July 2019 to check whether the practice was providing safe care.

We based our judgement of the quality of care at this service is on a combination of:

• what we found when we inspected;
• information from our ongoing monitoring of data about services; and
• information from the provider, patients, the public and other organisations.

At this focused inspection on 9 July 2019, we found the practice had made improvements.

We have rated this practice as good overall.

We rated the practice as good for providing safe services because:

• Following our previous inspection, the practice had reviewed all patients prescribed high risk medicines to ensure any patients requiring action were dealt with appropriately and the practice discussed the results of this review at a clinical meeting.
• The practice had created prescribing protocols for methotrexate, warfarin, lithium and azathioprine, and shared these with staff.
• We checked patient records and found there was evidence of appropriate monitoring and recording of patients’ test results, and no evidence of any unsafe prescribing.
• The practice had introduced additional failsafe processes, involving administrative staff as well as clinicians, to ensure patients on high risk medicines were monitored appropriately.

We also found the practice had acted upon a suggested area of improvement from the previous inspection, relating to encouraging the uptake of cervical and breast cancer screening rates:

• The practice was aware of the difficulty in increasing the uptake of cervical screening due to the high turnover amongst the younger and working age practice population.
• In January, April and June 2019 the practice had focused on calling in different age groups of women for cervical screening, as well as the usual monthly cervical screening recalls, to try and improve uptake.
• The practice showed us information on the clinical system which demonstrated that 61% of patients aged 25 to 49 years and 83% of patients aged 50 to 64 years had had a cervical screening in the last 3.5 years.
• The practice nurse is leading a project with the practice’s local network to have a public information stand situated in the local area to increase awareness and the importance of cervical screening amongst the local community; this is planned for January 2020.
• With regards to breast cancer screening, the practice is now actively monitoring the list of patients who do not attend the screening unit. The reception manager carries out regular searches to identify these patients and then the practice writes a follow-up letter to the patient, setting out the importance of the screening and providing contact details for the breast screening unit.
• Practice staff told us they are also monitoring patients who do not attend for bowel cancer screening and are following them up by letter.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection of Docklands Medical Centre on 6 February 2019 as part of our inspection programme.

At the previous inspection of Docklands Medical Centre on 20 November 2014 we rated the practice as good overall.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected;
• information from our ongoing monitoring of data about services; and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We rated the practice as requires improvement for providing safe services because:

• We found incidents of unsafe prescribing of some high risk medicines and there were no prescribing protocols in place for some high risk medicines.

We rated the practice as good for providing effective, caring, responsive and well-led services because:

• The practice reviewed and monitored the effectiveness and appropriateness of the care and treatment it provided.
• Patient feedback about the practice was positive and the practice acted upon feedback.
• The practice had an active patient participation group.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• There was a clear leadership structure and staff told us they felt able to raise concerns and were confident these would be addressed.
• There was a strong focus on continuous learning and improvement.
• The way the practice was led and managed promoted the delivery of high-quality and person-centre care.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Consider measures to encourage the uptake of cervical and breast cancer screening rates.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice