Letter from the Chief Inspector of General Practice
This practice is rated as Good overall. (Previous inspection 8 April 2015 – Good)
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? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
We carried out an announced comprehensive inspection at Ribbleton Medical Centre on 2 November 2017 as part of our inspection programme to inspect 10% of practices before April 2018 that were rated Good in our previous inspection programme.
At this inspection we found:
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The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. There was evidence that incidents were not always shared effectively with staff and the practice was working to improve this.
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The practice conducted safety risk assessments and staff recruitment processes were comprehensive. However, there were no occupational health checks undertaken for new staff to assess that working conditions were appropriate. Staff told us that these would be introduced in the future.
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The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
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When GPs were very busy, they asked staff to work to a practice protocol to process some normal patient test results without sight of a GP. This protocol was comprehensive but there was no audit of its use to ensure that it was followed correctly.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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When patients reported problems in accessing the appointment system the practice worked to resolve these and had introduced a new telephone system. They had recruited an advanced nurse practitioner to improve access to clinicians from January 2018.
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There was a proactive approach to managing the skill mix of staff needed to provide best care to patients. Staff felt respected, valued and supported.
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Quality improvement issues were discussed in regular staff meetings. Clinical matters were discussed in weekly meetings although there were no formal minutes kept for these meetings.
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There was a strong focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider should make improvements are:
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Continue to develop a system to allow better communication of safety incidents to all staff and to record and share clinical discussion.
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Introduce occupational health screening for new staff to assess whether working conditions are appropriate.
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Introduce an audit process to ensure that the practice protocol for staff filing patient test results has been followed correctly.
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Take steps to better identify patients on the practice list who are also carers.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice