Belford Medical Practice

Letter from the Chief Inspector of General Practice

At our previous inspection on 7 October 2014, we rated the practice as good overall. At this inspection, we have also rated the practice as good overall.

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 Belford Medical Practice on 23 January 2018, to check that the provider continues to meet the legal requirements and regulations associated with the Health and Social Care Act 2008.

At this inspection we found:

• The practice had clear systems to manage risk, so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• Overall, patients received safe care. However, there were shortfalls in relation to some aspects of the practice’s arrangements for managing medicines such as vaccinations, which could pose a risk to patient safety.
• The practice routinely reviewed the effectiveness and appropriateness of the care and treatment they provided. Staff ensured that care and treatment was delivered in line with evidence-based guidelines.
• Results from the NHS National Patient Survey showed patients were treated with compassion, dignity and respect, and were involved in decisions about their care and treatment.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice planned and co-ordinated patient care with the wider multi-disciplinary team, to deliver responsive care to patients with complex health needs, or those living in vulnerable circumstances.
• The practice had good facilities and was well equipped to treat and meet patients’ needs.
• GP staff held lead roles in the areas of learning disabilities, research and diabetes within the wider health community. They proactively collaborated with their local Clinical Commissioning Group, and other local practices, to influence and drive improvements in the delivery of patient care within the locality.
• Overall, there were clear responsibilities, roles and systems of accountability to support good governance and management.

We saw areas of outstanding practice:

• Feedback from patients about access to appointments and the quality of their care and treatment was consistently very positive. The results of the NHS National GP Patient Survey, published in July 2017, placed the practice in the top five best performing surgeries in the North East, and in the top 20 surgeries nationally. Data from the survey showed patients rated the practice significantly higher for all aspects of care, when compared to the local CCG and national averages. This high level of achievement had been sustained over a number of years. In particular, 100% of patients described their overall experience of this practice as good.
• The practice had consulted an expert-by-experience from a charity for people with a learning disability, to help them identify what improvements they could make to the services they provided to patients with learning disabilities. Also, following feedback from local dementia awareness professionals, the practice had taken steps to make the premises and their services more accessible to patients with dementia. This included trialing a dementia research kiosk, which facilitates the involvement of patients with dementia, and their carers, in relevant research projects.
• Staff from the practice actively supported a local dedicated charity, which raises money to provide equipment for patients registered with the practice. For example, over the past 12 months, patients had been able to benefit from the purchase of blood sugar testing and electrocardiograph machines, which meant they were able to receive care and treatment closer to home.

We identified one regulation that was not being met. The provider must:

• Ensure care and treatment is provided in a safe way to patients. We identified some shortfalls in relation to the management of medicines, particularly in relation to ensuring that the correct legal authority was in place for non-clinical staff to administer vaccinations.

The areas where the provider should make improvements are:

• Review the dispensary’s Standard Operating Procedures to ensure they are fit for purpose, reflect current practices and are fully implemented. In particular, those relating to: monitoring refrigerator temperatures; safe custody of prescriptions; completion of medicine reviews.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice