Archived: St Lukes Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an inspection of St Lukes Medical Centre on the 7 September 2016. This review was performed to check on the progress of actions taken following an inspection we made in April 2016. Following that inspection the provider sent us an action plan which detailed the steps they would take to meet their breaches of regulation. During our latest inspection on 7 September 2016 we found the provider had made the necessary improvements.

This report covers our findings in relation to the requirements and should be read in conjunction with the report published in August 2016. This can be done by selecting the 'all reports' link for St Lukes Medical Centre on our website at www.cqc.org.uk

Our key findings at this inspection were as follows:

The practice ensured the health and safety for patients by improving the arrangements for managing medicines (vaccines). This included the introduction of:

• Secure systems for the storage and distribution of prescription stationary.
• A system where patient group directions (PGDs) were kept under review.
• A process to frequently conduct Medicines and Healthcare product Regulatory Agency (MHRA) searches to check for any medicine alerts.
• Further processes to monitor rises and drops in fridge temperatures.

The practice had sought feedback from patients following lower than national average scores in January 2016. The national survey results from July 2016 remained lower than average for GP interactions but internal survey findings in March 2016 had been positive.

The practice had improved the governance systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk. This included the introduction of:

• Written care plans for all patients with the long term conditions including chronic obstructive pulmonary disease and diabetes.
• Written records for palliative care meetings.
• Clearly displayed chaperone signs in every treatment room and waiting areas.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Lukes Medical Centre on 5 April 2016. Overall the practice is rated as requires improvement.

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.
• The assessment of risks to patients required improvement. For example, security relating to prescription forms and the introduction of care plans for patients with some long term conditions.
• Insufficient arrangements were in place for the safe storage of vaccines and the monitoring of the Medicines and Healthcare products Regulatory Agency (MHRA) alerts.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a number of written procedures to govern activity, but some were overdue a review. For example, the patient group directions (PGDs are documents permitting the supply of prescription only medicines to patients, without individual prescriptions).
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider must make improvement are:

The arrangements for the secure storage and audit of prescriptions and systems to monitor their use, including in treatment rooms.

The practice needed written evidence to demonstrate that it had regularly reviewed its patient group directions (PGDs are documents permitting the supply of prescription only medicines to patients, without individual prescriptions).

The practice needed to ensure a robust system for actioning Medicines and Healthcare products Regulatory Agency (MHRA) alerts from Public Health England was in place. MHRA alerts were being received and actioned, up until January 2016 when a change of staff had occurred. When this was brought to the practice’s attention, action was taken.

The areas where the provider should make improvements are:

Ensure that patients with long term conditions such as diabetes or Chronic Obstructive Pulmonary Disease (COPD) are provided with a written copy of their own care plan. At the time of the inspection we found that patients with chronic obstructive pulmonary disorder (COPD) or diabetes had not been provided with a written copy of their own care plan.

The practice should review its arrangements for the recording of palliative care meetings.

The practice needed to consider how it communicated with patients who were hard of hearing at St Lukes Medical Centre.

Professor Steve Field

CBE FRCP FFPH FRCGP