The Queen Edith Medical Practice

Updated 22 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of thi s practice on 10 May 2016. We set a requirement in relation to safe care and treatment. The practice sent in an action plan informing us about what they would do in relation to the area where they needed to improve;

• Healthcare assistants must have authorisation from a prescriber for each medicine or vaccination they administer.

During the initial inspection we also found other areas where improvements were required:

• Complete and review actions resulting from infection control audits in a timely manner and implement practice wide infection control training.
• Review the visibility in the waiting areas to ensure the safety and security of vulnerable patients.
• Identify carers more proactively.
• Undertake fire drills at the required intervals.
• Take more proactive steps to try and improve cervical cytology rates.
• Record and learn from all verbal complaints.

We undertook a desk based inspection on 29 November 2016 to make a judgement about whether their actions had addressed the area they needed to improve. Actions had been undertaken to address this area. The practice also told us the majority of the areas for improvement had been addressed and provided us with statements and/or evidence to demonstrate this.

The overall rating for the practice is good. You can read our previous report by selecting the ‘all reports' link for on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 August 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2014/2015 showed that:

• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 4 August 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were higher for some of the standard childhood immunisations but slightly lower for others. For example, data from 2014/2015 showed the percentage of children receiving the PCV vaccination for the age group of 12 months was 91.7% compared to the CCG average of 94.7%, whereas the percentage of children receiving the meningitis C vaccination for the age group of 24 months was 94.7% compared to the CCG average of 92.6%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses. Midwife clinics were held at the practice on a weekly basis.

Updated 4 August 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice was flexible with appointments to allow patients to attend with carer’s availability.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure, were in line or above local and national averages.

Updated 4 August 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group. The practice’s uptake for the cervical screening programme was 73%, which was below the CCG and England averages. However, the exception reporting rate for the practice rate was 5%, which is lower than the CCG average of 8% and the England average of 6%.

• The practice provided telephone triage slots in every morning clinic to give advice to those who could not attend the practice.

• The practice only closed for 30 minutes at lunchtime to allow extra time for working age people to collect prescriptions and make appointments. Appointments were also bookable online.

Updated 4 August 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 95% of patients experiencing poor mental health had a comprehensive, agreed care plan documented in their record in the preceding 12 months, which is above the England average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 4 August 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice had a proactive approach in registering patients at the practice who were homeless.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.