Archived: Camden Health Improvement Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Camden Health Improvement Practice on 05th January 2017. Overall, the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events. Incidents were reviewed by the provider’s Risk and Assurance Team at the charity’s headquarters.

• Lessons were shared to make sure action was taken to improve safety in the practice.

• When things went wrong patients received reasonable support, truthful information, and a written apology. They were told about any actions to improve processes to prevent the same thing happening again.

• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

• There were a range of quality and safety audits carried out based on the provider’s Internal Quality Assessment Tool.

• The practice provided a range of evidence based services designed to meet the needs of the patients served by the practice.

• A health navigator was employed by the practice, funded by the local CCG to support patients to ensure they attended hospital or other appointments. Patients released from prison or a mental health hospital sometimes needed help to understand where and how to access services.

• The practice liaised with the Camden out of hour’s service (OOH). The practice received information daily about patients who had attended the out of hour’s service overnight and they alerted the OOH service about any patients concerns identified during the day.

• GPs and nurses told us they encouraged patients to have tests, investigations and treatment. They said it was important to respect patient’s wishes if they declined to have a test or treatment even if they were at risk of developing a condition.

• GPs and nurses told us they used every opportunity they saw patients to check their general health.

• One doctor co-ordinated the care for patients approaching the end of life. The practice held a palliative care register. The care of patients on the register was discussed a clinical review meetings

• Patients’ needs were discussed at a weekly meeting. Patients’ clinical and social needs were discussed.

• The practice employed a locum GP with funds from a homeless charity visiting homeless patients on the street and in hostels.

• The practice had a bank of locums they could call on to cover sessions during periods of sickness or other absences.

• The learning needs of staff were identified through a system of appraisals, meetings and reviews of practice development needs. Nursing staff had access to professional supervision.

• The practice could organise appointments for patients up to a year ahead. This meant patients could be monitored frequently for example to review their medicines.

• Reception staff kept an appointment slot free for emergencies in each of the afternoon clinic sessions. Nurses also help one urgent slot for seeing patients urgently.

• The appointment system was designed to allow patients to access service by use of drop in clinics.

• An on site phlebotomy so that patients did not have to go somewhere else they not know for tests.

• The practice analysed the complaints received identified any lessons learned and monitored any trends and actions taken to as a result to improve the quality of care.

• There was a range of quality and safety audits carried out based on the provider’s IQAT (Internal Quality Assessment Tool.

• The practice was participating in a safety improvement programme which developed capacity within the practice to pursue quality improvement.

The areas where the provider should make improvement are:

• The practice should ensure blank prescription forms are kept in a locked area at all times.

• Cupboards where clinical equipment is stored should be locked.

• The practice should review Patient Group Directions which are beyond review date and ensure all PGDs are signed.

• The provider should carry out a comprehensive risk assessment of security or staff and patients at the service.

• The practice should ensure staff complete all mandatory training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice