Archived: Manor Way Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Manor Way Surgery on 20 July 2016. Overall the practice is rated as requires improvement.

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

• Although risks to patients who used services were assessed, the systems and processes to address these risks were not implemented well enough to ensure patients were kept safe.

• For example there was an absence of a monitoring system for patients prescribed with medicines that required additional blood tests.
• Patient outcomes were hard to identify as little or no reference was made to audits or quality improvement and there was limited evidence that the practice was comparing its performance to others; either locally or nationally.

• The practice did not have a clear overarching governance framework to support the delivery of the strategy for good quality care. There were limited arrangements for the management of a programme of clinical audit and the management of governance of nurses delivering ,minor illness clinics. Although some reviews had been carried out, we saw limited evidence that audits were driving improvements to patient outcomes.

• Patients were positive about their interactions with staff and 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

The areas where the provider must make improvements are: 

• Implement formal governance arrangements including systems for assessing and monitoring risks and the quality of the service provision. For example implement a system to manage and monitor patients on high risk medicines.
• Manage and monitor the governance arrangements in which prescriptions are generated for patients medicines in the absence of suitable prescribing qualifications, particularly during the nurse minor illness assessment clinic process.
• Ensure a programme of quality improvement and clinical audits is implemented to effectively monitor patient outcomes.
• Ensure all patients have access to appropriate health assessments and checks, particularly for patients with learning difficulties.

In addition the provider should:

• Review the use of patient friends and relatives for translation purposes in order to preserve confidentiality.
• Review the development of a more active Patient Participation Group to increase patient engagement, encouraging surveys and feedback.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice