Archived: King Street Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at King Street Medical Centre on 17 November 2015. Overall the practice is rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, reviews and investigations were not thorough enough.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Although some audits had been carried out, we saw no evidence that audits were driving improvement in performance to improve patient outcomes.
• The majority of patients said they were treated with compassion, dignity and respect.
• Urgent appointments were usually available on the day they were requested.
• The practice had a number of policies and procedures to govern activity, but some were overdue a review.
• The practice had proactively sought feedback from patients and had an active patient participation group.

Outstanding practice

• The practice was family friendly and all staff including the GP’s, practice nurse, practice manager and receptionists knew the patients well and most by first name as patients had been attending the practice for many years.

• The service being provided was caring and responsive despite the high level of deprivation, the higher percentage (74.7%) of its population claiming disability allowance than the England average of (50.3%) and having a relatively high patient population of approximately 30% ethnic minorities.

The areas where the provider must make improvements are:

• Ensure recruitment arrangements include all necessary employment checks for all staff employed by the practice and for locum / agency staff. This includes the need for a Disclosure and Baring Service (DBS) check when appropriate.

• Ensure staff files are monitored regularly to make sure they contain the appropriate checks and paperwork.

• Ensure all staff have the relevant training to carry out their role and responsibilities, for example, safeguarding training.

• Ensure all staff receive supervision and appraisal within appropriate timescales.
• Ensure clinical and non-clinical audits, such as infection control audits, and re-audits are implemented to improve patient outcomes.
• Ensure there is a system to monitor the traceability of the prescription paper used in the practice.

In addition the provider should:

• Review and update procedures and guidance.
• Assign roles, such as the infection prevention and control lead, appropriately with job descriptions and ensure staff are aware of the roles and responsibilities they have.
• Review and update the business continuity plan to take into account information technology based eventualities.
• Schedule regular and staff meetings with minutes available to be shared to all staff.
• Improve on the recording and reviews of significant event reviews to include more information.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice