Letter from the Chief Inspector of General Practice
We carried out an announced focused inspection of Dr Bevan and Partners on 28 March 2017. This was to check that improvements had been made following the breach of legal requirements we identified from our comprehensive inspection carried out on 18 May 2016. During our inspection in May 2016 we identified a regulatory breach in relation to:
- Regulation 12 HSCA (RA) Regulations 2014 safe care and treatment
This report only covers our findings in relation to the areas identified as requiring improvement following our inspection in May 2016. You can read the report from this comprehensive inspection, by selecting the 'all reports' link for Dr Bevan and Partners on our website at www.cqc.org.uk. The areas identified as requiring improvement during our inspection in May 2016 were as follows:
- Ensure appropriate systems are in place for the proper and safe management of medicines including dispensing, audit, recording and destruction of controlled drugs and followed correctly and that standard operating procedures contain all the relevant information.
In addition, the practice were told they should:
- Ensure staff receive appropriate training and appraisals; update training for dispensary staff in dispensary procedures including management of controlled drugs and update training in infection control and infection control audit.
- Continue to identify and support carers.
- Advise patients at the branch surgery what to do when the dispensary is closed.
- Implement a system to provide an audit trail for blank prescriptions at the branch practice.
Our focused review on 28 March 2017 showed that improvements had been made and our key findings across the areas we inspected were as follows:
- The practice had arranged a training session for dispensary staff in managing controlled drugs (medicines that require extra checks and special storage because of their potential for misuse) and they had put procedures in place to manage them safely. One member of staff had not yet qualified as a dispenser, and was fully supervised when dispensing controlled drugs.
- The controlled drugs policy had been revised to include details of the NHS England Controlled Drugs Accountable Officer.
- Controlled drugs were stored in a controlled drugs cupboard, access to them was restricted and the keys held securely.
- There were arrangements in place for the destruction of controlled drugs, and the out of date stock we saw at our last inspection had been disposed of in the presence of an authorised witness. Records were kept in line with controlled drugs legislation.
- We saw records of regular checks on controlled drugs stock, and a three monthly report was made to the practice clinical meeting. During one of the routine checks, staff had identified a discrepancy which had been appropriately recorded, reported and investigated. The controlled drugs procedure had been revised to reduce the risk of this type of error happening again.
- Blank prescriptions at the branch surgery were stored securely and the practice had introduced a log of serial numbers to monitor their use in line with national guidance.
- In the afternoons when the dispensary was closed, prescriptions and dispensed medicines could be collected by arrangement at the main surgery in Irthlingborough, or the prescription could be sent to a community pharmacy to be dispensed. The practice had taken to steps to ensure patients were aware of who to contact when the dispensary was closed.
- The practice held a register of patients identified as carers and promoted support services available to carers and including information in patients areas in order to identify and support carers.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice