Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Lane End Medical Group on 16 October 2014. Overall the practice is rated as requires improvement.
Specifically, we found the practice to be good for providing effective, caring and well led services. We rated the practice as requires improvement for providing services for older people, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, people experiencing poor mental health (including people with dementia) and for people with long term conditions. It required also improvement for providing safe and responsive services.
Our key findings across all the areas we inspected were as follows:
- During our inspection, we observed that reception staff treated patients with dignity and respect;
- The practice had recognised the needs of different groups in the planning of its services. For example, a receptionist outlined the steps taken to help vulnerable patients who needed additional support to understand and be involved in their care;
- Records showed the practice used significant events to improve the service and we noted that learning points were shared at team meetings. However, we also found that learning outcomes from complaints received were not always shared with staff;
- We saw evidence that clinical audits were being used to help improve patient outcomes but noted the absence of a systematic clinical audit programme;
- The practice participated in a national performance measurement tool called Quality Outcome Framework (QOF). We saw that performance was above the Barnet and England practice average in a number of clinical areas such as dementia, coronary heart disease and childhood immunisations.
- There was a strong focus on continuous learning and improvement at all levels of the organisation. This was supported by GPs’ involvement in part time undergraduate, post graduate teaching and by nurse practitioner involvement in a local practice nurse mentoring scheme.
We saw evidence of outstanding practice:
- GPs had experience of contributing to child protection hearings in person or by submitting reports.
However, there were areas of practice where improvements were needed. Importantly, the provider must:
• Carry out Disclosure and Barring (DBS) checks on all staff who undertake chaperone duties at the practice.
In addition, the provider should;
- Ensure that learning outcomes from all complaints are identified and shared;
- Introduce a timetabled policies and procedures review programme to ensure they are fit for purpose;
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Ensure that the necessary locum GP pre-employment checks have taken place and are on file (for example we noted that a record of Hepatitis B vaccination status was not on file for one of the locum GPs).
- Continue working with its Patient Participation Group to make further telephone access improvements.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice