Archived: Balham Health Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the SELDOC Out of Hours Service at Balham Health Centre on 9 September 2017. Overall the service is rated as good.

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

• The arrangements for managing medicines at the service did not always keep patients safe. Medicines audits had been introduced but were not yet completed, with one cycle being carried out, and as such did not demonstrate actions identified had been implemented or were effective in making improvements in prescribing and medicines management. The provider did not record the dispensing of medicines in line with guidelines. The provider utilised medicines of another provider at the same premises but did not have formal systems in place to ensure that stocks were monitored.

• The service did not carry medical gases such as Oxygen, or an Automatic External Defibrillator (AED) in vehicles used for home visits and did not have a documented risk assessment mitigating their absence.

• There were clearly defined and embedded systems and processes in place to keep patients safe and safeguarded from abuse.

• There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
• Patients’ care needs were assessed and delivered in line with current evidence based guidance and in a timely way according to need. The service met the relevant National Quality Requirements.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• There was a system in place that enabled staff access to patient records, and the out of hours staff provided other services, for example the local GPs and hospital, with information following contact with patients as was appropriate.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.
• The service 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. The service proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider must make improvement is:

• Develop effective systems and processes to ensure safe care and treatment including ensuring the proper and safe management of medicines, and assessing the risk of not providing Oxygen and Automatic External Defibrillator on service vehicles used for home visits and, where appropriate, mitigate their absence.

The area where the provider should make improvement is:

• Ensure that risk assessments undertaken by the building owner are available to the provider.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice