Background to this inspection
Updated
6 February 2020
Bexley Medical Group is located at 171 King Harolds Way. Bexleyheath, DA7 5RF. The practice also operates from two branch surgeries located at: Hurst Place Surgery, 294A Hurst Road, Bexley, Kent, DA5 3LH and Erith Health Centre, 50 Pier Road, Erith, Kent, DA8 1RQ
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning services, surgical procedures and treatment of disease, disorder or injury.
Bexley Medical Group is situated within Bexley Clinical Commissioning Group (CCG) and provides services to approximately 17,500 patients under the terms of a personal medical services (PMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
The practice is a partnership consisting of two GP partners; one male and one female. The practice also employs eight salaried GPs of mixed genders. The practice provides a total of 58 GP sessions, one full time and one part time clinical pharmacist, four part time nurses and one part time healthcare assistant.
The age demographics were broadly comparable to those of other practices within the CCG and nationally although this practice has a slightly lower proportion of children. The percentage of patients not in employment is just above half the national average and the practice has a slightly higher proportion of patients with long standing health conditions. The National General Practice Profile states that 17% of the practice population is from a black ethnic background. Information published by Public Health England rates the level of deprivation within the practice population group as seven, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The practice has comparable levels of deprivation affecting children and approximately half the level of deprivation affecting older people compared to the national average.
Updated
6 February 2020
Bexley Medical Group is a provider registered with CQC.
We carried out an inspection of Bexley Medical Group on 12 and 27 November 2019 because of concerns we received about the provider.
This inspection focussed on the key questions of Safe, Effective and Well-led.
Because of the assurance received from our review of information we carried forward the ratings for the key questions caring and responsive.
We rated the practice as good overall with the following key question ratings:
Safe – Requires improvement
Effective – Good
Well-led – Good
The practice had previously been inspected 24 April 2019 and had been rated as good overall and in four of the five key questions; safe was rated as requires improvement.
We based our judgement of the quality of care at this service on a combination of:
• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.
We have rated this practice as good overall: safe remains rated as requires improvement and we rated them as good for being effective and well led. Whilst they are rated as good for providing effective services, the population group of people experiencing poor mental health (including people with dementia) was rated as requires improvement.
We rated the practice requires improvement for providing safe services because:
- The practice had clear systems, practices and processes to keep people safe and safeguarded from abuse. However, some health and safety systems did not operate effectively; particularly in relation to some aspects of fire safety, infection prevention and control, dealing with medical emergencies, and managing prescription stationery.
- The practice had partial arrangements in place to ensure staff vaccinations were completed in accordance with published guidance.
- Appropriate standards of cleanliness and hygiene were met but the service had not assessed risks associated with infection control at all their practice sites
- There were adequate systems to assess, monitor and manage risks to patient safety, but some arrangements for dealing with medical emergencies were in need of review.
- The practice had systems for the appropriate and safe use of medicines, including medicines optimisation. However, the management of prescription stationery was in need of further review.
We have rated the practice as good for providing effective services because:
- Patients’ needs were assessed, and care and treatment was delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
- The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
- The practice was able to demonstrate that staff had the skills, knowledge and experience to carry out their roles.
- However, we have rated the practice as requires improvement for providing effective services for people experiencing poor mental health (including people with dementia) as they had high exception reporting rates for patients in this population group, and these rates were higher than the previous year.
We rated the practice good for being well led because:
- There was compassionate, inclusive and effective leadership at all levels.
- There were clear responsibilities, roles and systems of accountability to support good governance and management.
- There were clear and effective processes for managing most risks, issues and performance. However, staff did not have oversight of some health and safety risks.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way to patients
(Please see the specific details on action required at the end of this report).
The areas where the provider should make improvements are:
- Continue to review areas of high QOF exception reporting to ensure they are taking all practical steps to provide people with the care and treatment they need.
- Continue with their current work programme to improve the service offered to patients with learning disabilities.
- Continue to review physical access arrangements at the King Harold’s Way location.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.