Letter from the Chief Inspector of General Practice
We carried out an announced inspection of Dr Spencer and Partners on 20 August 2015. This was a comprehensive inspection under Section 60 of the Health and Social Care Act (2008) as part of our regulatory functions. The practice achieved an overall rating of requires improvement. Specifically, we found the practice to require improvement for providing safe, effective, responsive and well-led services. We found it to be good for providing caring services. Consequently, it requires improvement for providing services for older people; people with long-term conditions; families, children and young people; working age people; people whose circumstances may make them vulnerable and people experiencing poor mental health.
Our key findings were as follows:
- Systems were in place to identify and respond to concerns about the safeguarding of adults and children.
- We saw patients receiving respectful treatment from staff. Patients felt they were seen by friendly and helpful staff. Patients reported feeling satisfied with the care and treatment they received.
- The practice offered a number of services designed to promote patients’ health and wellbeing and prevent the onset of illness.
- The practice acted upon best practice guidance to further improve patient care.
- The management and meeting structure ensured that appropriate clinical decisions were reached and action was taken.
- The practice appeared clean.
- Systems to ensure the appropriate management of medicines were lacking or not fully implemented.
- Adequate procedures for completing the required background checks on staff were lacking.
- A programme of repeated (full cycle) clinical audit which demonstrates learning and the effectiveness of any changes made was lacking.
- Some patient feedback was that access to appointments was poor and getting through to the practice by phone was difficult. The wait for some advance release pre-bookable appointments was long.
There were areas of practice where the provider needs to make improvements.
Importantly, the provider must:
- Ensure an appropriate system is in place for the safe use and management of medicines and medical consumables, including those used in an emergency.
- Ensure that all applicable staff receive a criminal records check and that the required information is available in respect of the relevant persons employed.
- Ensure there is a programme of repeated (full cycle) clinical audit which demonstrates learning and the effectiveness of any changes made. Ensure that all relevant staff are aware of the outcomes and learning of any audits completed.
- Take steps to reduce the waiting time for routine pre-bookable appointments and improve patients’ access to the practice by telephone.
In addition the provider should:
- Ensure that systems designed to assess the risk of and to prevent, detect and control the spread of infection are fully implemented and audited appropriately. Staff should be trained in relation to infection control processes and procedures.
- Ensure that the non-clinical staff yet to complete cardiopulmonary resuscitation (CPR) essential training do so.
- Ensure that all staff employed are supported and are receiving the appropriate supervision.
- Take steps to improve staff communication and the opportunities for staff to be involved in discussions about the strategic direction of the practice and to have their views considered.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice