Archived: Poland Medical

Updated 17 May 2023

Background to Poland Medical

Poland Medical provides an independent doctor service and is located at 364A Whitton Avenue East, Greenford, UB6 0JP. The service is primarily aimed at the local Polish speaking community and is located on the ground floor of a converted residential property. The service is open Monday – Saturday 8:00am - 8:00pm and Sunday 10:00am – 6:00pm. Services are only available on a pre-bookable appointment basis. The clinic employs eleven doctors on a sessional basis all of whom are registered with the General Medical Council (GMC) with a license to practice. Most doctors are specialists providing a range of services which includes paediatrics, gynaecology, cardiology and orthopaedics. Administrative support is provided by a practice manager and a small team of reception staff.

Poland Medical is registered with the Care Quality Commission to carry out the regulated activities of Family Planning, Surgical Procedures, Treatment of disease, disorder or injury and Diagnostic and screening procedures.

Updated 17 May 2023

This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Inadequate

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

Poland Medical provides an independent doctor service and is based in Greenford, outer West London. The service has a Registered Manager. A Registered Manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We carried out an announced comprehensive inspection at Poland Medical on 27 February 2023 as part of our inspection programme.

Our key findings were:

• Individual care records were not written in a way that kept patients safe. For example, our review of a selection of patient records highlighted an absence of examination findings or of evidence that patients had been advised on actions to take if their condition worsened changed or failed to improve. This presented a risk to patients in that records contained insufficient information to either support diagnoses or enable other health care professionals to understand and interpret clinical decision making.
• The provider had not ensured they had all the details of the patient’s health from their NHS GP prior to starting treatment which meant there was a risk they were not aware of all relevant healthcare needs. We noted they did gain patient’s consent to share details of treatment with their NHS GP.
• Patient records did not always include the necessary details of prescribed medication including frequency, duration and quantity.
• From November to December 2022 there had been three recorded incidents of prescription fraud. Although the service recorded significant incidents, staff did not carry out a root cause analysis, to support shared learning and minimise chance of recurrence. At the time of the inspection whilst prescription pads were being stored securely, individual prescriptions were not being monitored.
• Risks associated with infection prevention and control were not all being regularly checked (for example regarding a bacterium called Legionella which can proliferate in building water systems).
• Issues to do with patient safety, incidents and complaints were discussed at team meetings. However, most staff could not attend the meeting and relied on reading meeting minutes to identify learning. These minutes were very brief and did not contain sufficient detail.

• These concerns did not provide assurance that the service’s internal audit systems were having a positive impact on quality governance.
• Governance arrangements did not always operate effectively (for example regarding systems for logging safety alerts and learning from significant incidents).

However:

• There were clearly defined and embedded systems and processes to keep patients safe and safeguarded from abuse.
• Access to appointments and services took account of people’s language needs.
• Patients fed back they were treated with kindness, respect and compassion.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure patient records include all the necessary details including details of prescribed medication to deliver safe care and treatment (Regulation 17).
• Ensure the provider liaises with the patients NHS GP where applicable to obtain all necessary healthcare information to be able to deliver safe treatment (Regulation 12).
• Take the necessary steps to ensure the safe management of individual prescriptions (Regulation 12).
• Ensure individual incidents are fully investigated to look at the root cause to minimise the risk of recurrence and ensure learning (Regulation 12).
• Review and strengthen internal systems of assurance such as audits to deliver effective governance arrangements for the surgery (Regulation 17).

The areas where the provider should make improvements are:

• Ensure team meetings are properly recorded for staff who cannot attend in person.