Drs Smith and Taylor Also known as Victoria Medical Centre PMS Practice

We carried out an announced comprehensive inspection at Drs Smith and Taylor, known to patients as Victoria Medical Centre on 15 January 2019 as part of our inspection programme.

We decided to undertake an inspection of this service following our annual review of the information available to us and to follow up on the previous breach of regulation served at the January 2019 inspection. This inspection looked at the following key question:

• Well-led

Because of the assurance received from our review of information we carried forward the ratings for the following key questions:

• Safe
• Effective
• Caring
• Responsive

At the last inspection in January 2019 we rated the practice as requires improvement for providing well-led services because:

• The practice did not have clear and effective processes for managing risks, issues and performance.
• Practice policy was not always followed regarding infection prevention and control.
• The immunisation status of staff was not kept.

At this inspection, we found that the provider had satisfactorily addressed these areas.

We based our judgement of the quality of care at this service is 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.

We rated the practice as good for providing well-led services because:

• The processes for effectively managing risks, issues and performance had been improved.
• Records of staff immunity status was now kept and all staff had completed infection prevention and control training.

In addition we saw the practice had acted on the shoulds identified at the last inspection. 

• We saw that a protocol had been developed for staff to follow when dealing with paper correspondence into the practice. There were clear processes to follow for items that required review from a GP.  To support this process the on-call GP based themselves with administrative staff in the afternoon.
• Emergency equipment and medicines are now checked weekly and in-date defibrillator pads were now stocked.
• A log of safety alerts into the practice was now kept. The log detailed who reviewed the alert, the action to be taken and when it was completed.
• The practice had reviewed their appointment system to improve access to appointments for patients.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection at Drs Smith and Taylor, known to patients as Victoria Medical Centre on 15 January 2019 as part of our inspection programme.

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 and good for all population groups with requires improvement in well led as systems to identify risks required review.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm, although there were some shortfalls with regard to lack of risk assessments and safety alerts that had not been actioned.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. However, patients we spoke with told us they could not always access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, patient-centred care.

The areas where the provider must make improvements as they are in breach of regulations are: 

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are: 

• Improve the process for actioning hospital letters and formalise the protocol of what letters are forwarded to a GP for action.
• Review Resuscitation Council (UK) guidelines with regard to the frequency of the emergency equipment checks and take action to replace the out of date defibrillator pads.
• Review the system for actioning safety alerts to ensure that they are shared with relevant staff and all know who has taken action.
• Listen to patient feedback regarding access by telephone and to an appointment.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice