Archived: Fernbank Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fernbank Medical Centre on 17th November 2016. Overall the practice is rated as requires improvement.

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

• Systems and processes were not robust to keep patients safe. For example, appropriate recruitment checks on staff had not been undertaken prior to their employment.
• Performance levels on the Quality and Outcomes Framework (QOF) showed patient outcomes were consistently below the national average.
• Staff were clear about reporting incidents, near misses and concerns and there was evidence of sharing learning with staff to prevent incidents re-occurring.
• The practice had a leadership structure, however, there were no formal governance arrangements to monitor the quality of the service.
• The practice had a number of policies and procedures to govern activity, but some had not been reviewed to ensure they were up to date.
• Patients said they were treated with compassion, dignity and respect and felt cared for, supported and listened to but national patient survey data showed the practice was rated lower than others for several aspects of care.

The areas where the provider must make improvements are:

• Ensure that persons providing care or treatment have the qualifications,competence skills and experience to do so safely. Recruitment procedures must be effective and include all necessary pre-employment checks for staff including Disclosure and Barring Service (DBS) checks where appropriate, references and indemnity insurance.
• Review governance arrangements to ensure systems arein place to assess, monitor and mitigate the risks relating to the health,safety and welfare of service users. This must include:
• Effective systems to monitor any emerging trends from complaints which require service improvement.
• Reviewing and update procedures and guidance such as the protocol for managing patients with diabetes to ensure they reflect current best practice.
• Identifying areas of lower performance and having a clear plan to improve and address this to ensure the health and wellbeing of patients
• Records relating to the care and treatment of each person using the service were fit for purpose in that care plans were integrated into patient’s electronic records and updated regularly.

In addition the provider should:

• Be proactive in promoting cervical screening and raise awareness of the national breast and bowel screening program.
• Review the system to monitor the use of prescription forms and pads.
• Update the information leaflet for patients which was significantly out of date.
• Should consider ways to increase the patient voice and identify any further service improvements required.

Where a service is rated as inadequate for one of the five key questions or one of the six population groups or overall, it will be re-inspected within six months after the report is published. If, after re-inspection, the service has failed to make sufficient improvement, and is still rated as inadequate for any key question or population group or overall, we will place the service into special measures. Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid CQC taking steps to cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice