The Lanes Medical Practice

This service is rated as Good overall.

The previous inspection was in April 2018.

The inspection report for the previous inspection can be found by selecting the ‘all services’ link for The Lanes Medical Practice on our website at www.cqc.org.uk.

Since the April 2018 inspection, our methodology to regulate independent doctors and clinics providing primary care services has changed, the October 2019 inspection was therefore a rated inspection and the key questions are rated as:

•Are services safe? – Good

•Are services effective? – Good

•Are services caring? – Good

•Are services responsive? – Good

•Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at The Lanes Medical Practice in Stoke Poges, Buckinghamshire on 2 October 2019.

This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The Lanes Medical Practice is registered with Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Some of the services available at The Lanes Medical Practice, for example private GP service provision to patients under arrangements made by their employer and a government department, are exempt by law from CQC regulation.

Therefore, we were only able to inspect the services (private GP service and travel health services) which are not arranged for patients by their employers and government departments as part of this inspection.

The provider is an individual registered with CQC to manage the service. Individuals registered have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection, we received four completed comment cards which were all positive about the standard of care they received. The service advised due to the limited range of services (approximately 90% of the services provided are exempt from CQC regulation), the number of completed cards aligned to the size of the services we inspected.

All the comment cards were positive, further comments highlighted patients were satisfied with the standard of care received and thought the GPs and nurse were approachable, committed and caring. Several comments highlighted the wealth of knowledge within the travel health clinic which was easily accessible.

Our key findings were:

• The service had clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Patients received effective care and treatment that met their needs.
• The way in which care was delivered was reviewed to ensure it was delivered according to best practice guidance.
• For patients accessing the travel health clinic, the GPs and nurse recorded accurate travel plans including destinations, timescales and the reason for travel.
• All patient feedback was overwhelmingly positive, this included archived patient feedback recorded by the service included a variety of patient testimonials.
• Both the private GP services and travel health services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
• There were clear responsibilities, roles and systems to support good governance and management. However, the governance arrangements and supporting processes to verify patient identity required improvement.

The area where the provider must make improvements as there was a breach of regulations is:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. (Please see the specific details on action required at the end of this report).

In addition, the provider should:

• Complete the planned training programme to ensure all members of staff are trained to the correct level of safeguarding training (in line with current safeguarding intercollegiate requirements) for their role and responsibilities.
• Continue quality improvement activity for services subject to CQC regulation. This activity should include data evidencing improvement.