Archived: Dr F Rowe & Partners Also known as Howard House Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr F Rowe & Partners on 7 January 2016. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. There was scope to improve and extend learning from significant events.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment, and clinicians had lead areas of responsibility.

• Patient records were of a particularly high standard due to methodical and consistent use of readcodes.

• Feedback from patients about their care was consistently and strongly positive.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice used clinical audits to review patient care and took action to improve services as a result.

• Management of the practice formulary was strong and enabledpractice staff to support patients to manage their medicines in a safe and effective way.

• Patients said they were able to make appointments which suited them. Urgent appointments were available the same day.

• 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 sought feedback from staff and patients, which it acted on.

We saw one area of outstanding practice:

• The practice had appointed a Medicines Management Lead and this staff member had adopted a particularly robust system which ensured that patients received the medicines they needed in a safe and effective way. Extensive work around the practice formulary had been undertaken. The electronic prescribing system had been adopted comprehensively and resulted in patients being able to access medicines in a convenient way. An effective system was in place to ensure that newly registered patients could access their medicines in a safe way. A robust system was in place to ensure that GPs were alerted when reviews for patients taking high risk medicines were due. There was clear and effective oversight of hypnotic and sedative prescribing. The practice had adopted a particularly robust approach to ensuring that not only MHRA (Medicines Health and Regulatory Authority) alerts but also MHRA safety updates were disseminated to staff and acted upon.

However there were areas of practice where the provider should make improvements:

• There was scope to improve and extend learning from significant events. The practice should also consider whether some complaints merit investigation as a significant event in order to maximise learning.

• There was scope to improve the information provided by screen in the waiting room so thatpatients could better access and understand it.

• Doctors’ bags should not contain medicines already prescribed to a patient, unless intended only for use by that named patient.

• There was scope to improve the management of blank presciption forms and to ensure that an audit trail of usage was maintained.

• Nurse meetings should be minuted in order to provide future reference and for sharing with absent staff. Likewise, outcomes from mutli-disciplinary team meetings should be recorded in patient notes.

• Ensure that patients with depression are correctly read coded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice