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Swanswell Medical Centre Good


Inspection carried out on 6 December 2017

During an inspection to make sure that the improvements required had been made

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Swanswell Medical Centre on 6 October 2016. The overall rating for the practice was requires improvement with requires improvement ratings in safe and well-led services and good ratings in effective, caring and responsive services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Swanswell Medical Centre on our website at

This inspection was an announced focused inspection carried out on 6 December 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 6 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

  • The practice had made significant improvements to ensure that all patients requiring repeat prescriptions received appropriate reviews by their GP.
  • The practice monitored all blank prescriptions to ensure a clear audit trail.

  • The practice had carried out necessary health and safety risk assessments including fire risk assessments and taken any necessary actions.
  • The practice had made improvements to ensure all staff were aware of any significant events that had occurred and any learning that had taken place.
  • The practice had also made improvements to ensure all patients were informed of incidents when it was necessary.
  • Since our previous inspection, the practice had reviewed and updated a number of policies and procedures. For example, repeat prescribing to ensure effective processing of prescriptions and the staff training policy to enable more clarity on what the practice identified as mandatory training.
  • The practice had also made improvements to its system to monitor staff training levels.
  • All staff had received a recent appraisal and had a development plan in place.
  • Staff recorded outcomes from multidisciplinary meetings in patients’ notes and shared care plans with patients to give them the opportunity to comment.
  • The practice had reviewed its storage of clinical waste to ensure sharps bins were stored appropriately.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 6 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Swanswell Medical Centre on 6 October 2016. Overall the practice is rated as requires improvement.

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, systems for sharing learning with all staff were not well established and there was a lack of consistent approach to informing patients.
  • Risks to patients were not always assessed and well managed. For example, those relating to the premises and in relation to prescriptions and medicines.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • The latest published data (2014/15) showed patient outcomes were low compared to the national average. Although, more recent data available from the practice showed evidence of improvements.
  • Patients said they were treated with compassion, dignity and respect.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with same day and urgent appointments available.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. However, there was a lack of clear lines of communication between staff.
  • There was a proactive patient participation group which supported service improvement.

The areas where the provider must make improvements are:

  • Ensure robust processes are in place for repeat prescribing and the management of blank prescriptions.
  • Review systems for the identification and management of risks relating to the premises.

In addition the provider should:

  • Establish robust systems for the dissemination of information to all members of staff including learning from incidents and a consistent approach to informing patients as appropriate
  • Establish systems monitor and ensure staff are up to date with relevant training.
  • Ensure all staff receive annual appraisals to discuss their learning and development needs.
  • Ensure outcomes from multidisciplinary meetings are recorded in patient records.
  • Ensure all care plans are shared with patients and that they have the opportunity to comment.
  • Review systems for the storage of clinical waste.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice