Stanmore Medical Group

Letter from the Chief Inspector of General Practice

We carried out an unannounced focused inspection at Stanmore Medical Group on 15 August 2017. This was to check that improvements had been made following the breaches of legal requirements we identified from our comprehensive inspection carried out on 12 January 2017. During our inspection in January 2017 we identified regulatory breaches in relation to;

• Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014

- safe care and treatment.

• Regulation 17 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014

- good governance.

This report only covers our findings in relation to the areas requiring improvement as identified on inspection in January 2017. You can read the report from this comprehensive inspection, by selecting the 'all reports' link for Stanmore Medical Group on our website at www.cqc.org.uk.

The areas identified as requiring improvement during our inspection in January 2017 were as follows:

• Ensure the system for managing high risk medicines is effective and keeps patients safe.
• Review and strengthen its overall system for monitoring responses to safety alerts to ensure that any required actions are addressed.

In addition, the practice were told they should:

• Review training systems to ensure staff are up to date in areas such as basic life support.
• Continue to encourage patients to engage with the national screening programme for breast cancer.

Our focused inspection on 15 August 2017 showed that improvements had been made and our key findings across the areas we inspected were as follows:

• The practice had an effective system in place for the safe management of patients receiving high risk medicines.
• A system was in place to ensure the required actions were taken and recorded in response to safety alerts.
• Staff had completed training relevant to their roles, for example safeguarding and basic life support training.
• The practice had taken steps to encourage patients to engage with the national cancer screening programme.
• The processes in place for managing risks had been reviewed and improved.
• The practice had strengthened their governance arrangements and had introduced additional practice specific policies and risk assessments which were reviewed on a regular basis.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stanmore Medical Group on 12 January 2017. Overall the practice is rated as requires improvement.

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

• The practice had systems and processes in place to safeguard patients from abuse. There were protocols in place to review children who had not attended for hospital appointments, and to identify children who may be at risk of domestic violence or neglect (for example those with frequent attendances at Accident and Emergency).

• We checked a sample of recent alerts and found that the practice had not consistently taken action as a result of safety alerts.

• Not all patients who were prescribed high risk medicines were being monitored consistently.
• Staff we spoke with knew what to do in the event of a medical emergency and there was a suitable procedure in place which listed the emergency medicines in supply, but we found that one emergency medicine was missing on the day of the inspection. One member of non clinical staff did not have up to date basic life support training.
• The practice had a system to report and record incidents and significant events. Changes were implemented to prevent incidents happening again.
• Staff had access to up to date evidence based guidance and used this information to deliver care and treatment that met patients’ needs.
• Staff we spoke with during the inspection demonstrated that they had the skills, knowledge and experience to deliver effective care and treatment but the practice was not up to date with all staff training at the time of our inspection.
• Results from the National GP Patient Survey published in July 2016 showed that the practice’s performance in patient satisfaction was mixed, with results slightly lower than average in relation to GP consultations. Patient comment cards collected in the two weeks prior to the inspection were positive about the standard of care delivered.
• We observed staff to be kind and helpful to patients and to treat them with dignity and respect.
• 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 practice offered a good level of access to appointments, which were also available during extended hours and over the telephone. There was a dedicated call centre on the premises. Results from the National GP Patient Survey showed that patients’ satisfaction with how they could access care and treatment was in line with or in some areas significantly higher than both local and national averages.
• The practice 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 practice proactively sought feedback from staff and patients.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice had implemented a community cancer care clinic with support from Macmillan Cancer Support. Clinics were held every Monday for people with cancer in the Stevenage area, and offered advice, counselling and pain management.

The areas where the provider must make improvements are:

• Ensure the system for managing high risk medicines is effective and keeps patients safe.
• Review and strengthen its overall system for monitoring responses to safety alerts to ensure that any required actions are addressed.

In addition the provider should:

• Review training systems to ensure staff are up to date in areas such as basic life support.
• Continue to encourage patient s to engage with the national screening programme for breast cancer.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice