GP Health Partners at The Derby Medical Centre

This service is rated as Requires Improvement overall.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection at GP Health Partners Ltd as part of our inspection programme. This was the first inspection of this extended access service. Our inspection included a visit to the service’s headquarters and to three of the locations where the service operated. These were Derby Medical Centre, 8 The Derby Square, Epsom KT19 8AG, Heathcote Medical Centre, Heathcote, Tadworth KT20 5TH and Leatherhead Hospital Poplar Road, Leatherhead KT22 8SD.

Our key findings were:

• Patients were supported and treated with dignity and respect. Services were offered daily from several hub locations across the 19 practices, ensuring the service was accessible to all patients.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• Care and treatment was delivered according to evidence-based guidelines.
• Patients found the appointment system easy to use and reported they were able to access care when they needed it.
• The federation had reviewed the needs of their local population and ensured that additional services were offered. For example, cytology screening, asthma clinics and cardiology services.

However, we also found that:

• The service had not ensured care and treatment was always provided in a safe way to patients.
• The service was unable to assure themselves that people received effective care and treatment.
• The leadership and governance of the service did not assure the delivery of high-quality care.
• The service could not evidence that all the checks required to employ staff appropriately were in place.
• The service could not evidence that some clinical staff had been appropriately trained to undertake the tasks delegated to them.
• The service had not implemented effective systems to ensure appropriate and safe provision of emergency medicines and equipment.
• The service did not have systems and processes in place to ensure that safety alerts were managed effectively.
• We found that policies and procedures were not always written and shared with staff to govern activity and ensure staff were adhering to the same processes.
• The service did not have systems and processes to give assurance that staff would raise, share and record all significant events. There was no clear evidence to demonstrate that any identified learning was shared with the whole service team.
• The service did not always have oversight of the premises from where they delivered services. For example, the service had not reviewed premises management information sent from the host sites and had not followed up areas of non-compliance, so were unaware if the host sites had rectified problems found.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure staff who are suitably qualified, competent, skilled and experienced persons, are deployed to meet the fundamental standards of care and treatment.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure systems and processes for managing significant events and complaints are robust and there are mechanisms for sharing information and learning with all staff to encourage improvements.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief

Inspector of Primary Medical Services and Integrated Care