Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Pinhoe and Broadclyst surgery on 24 November 2015. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
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Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
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There was an open and transparent approach to safety and an effective system in place for reporting and recording 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.
- Risks to patients were assessed and well managed, with the exception to the storage of vaccinations, the security of blank prescriptions and the appropriate use of patient group directives by nurses.
- 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.
- 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
We saw several areas of outstanding practice - The practice was well led and responded to patient need and feedback. Innovative and proactive methods were used to improve patient outcomes even where no financial incentives or contractual agreements were expected:
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An additional service was provided by staff at the practice for patients with indwelling intravenous lines used for prolonged treatments such as chemotherapy, long term antibiotics and intravenous feeding. Patients were normally required to go to hospital for management of this intravenous line. However, staff at the practice had completed extended training to enable patients to receive care locally, at the practice.
However there were areas of practice where the provider must make improvements:
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Urgently review the arrangements for the storage of vaccines in the practice
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Review arrangements for prescribing under Patient Group Directions to ensure all meet current legislation and are authorised for use in the practice
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Review procedures for storing and recording blank prescriptions to ensure national guidance is followed
Complete a risk assessment re vaccine storage fridges and reduce or remove the risk of storage at temperatures outside of the safe range.
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Improve infection control procedures including an audit of all areas, infection control policy and protocol updates and all required staff to be trained to an appropriate level.
In addition the provider should
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice