Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at HHR Medical on 25 May 2017. The overall rating for the practice was good but requires improvement for the key question: Are services safe? The full comprehensive report on the 25 May 2017 inspection can be found by selecting the ‘all reports’ link for HHR Medical on our website at www.cqc.org.uk.
This inspection was a desk-based review carried out on 1 December 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 25 May 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.
Overall the practice remains rated as good and is now rated good for key question: are services safe?
Our key findings were as follows:
-
There was a consolidated child safeguarding policy which included all relevant information including the name of the practice lead.
-
The practice had systems in place to monitor handwritten prescriptions.
-
The practice were now reviewing uncollected prescriptions monthly and recording action taken in response to the review.
-
Printer prescriptions were stored in locked cabinets.
-
The most recently published Quality Outcomes Framework data for 2016/17 showed that some scores relating to the management of patients with diabetes were still below local and national averages. For example the percentage of patients with well controlled blood sugar was 61% compared with 76% in the CCG and 80% nationally).The practice informed us that the nurse was due to start a diploma in diabetes.
-
Performance had improved in respect of the percentage of patients with complex mental health conditions who had a care plan in place compared to the previous year (83% compared with 90% in the CCG and 90% nationally). However the percentage of patients with a record of alcohol consumption was still lower than local and national averages (75% compared with 91% locally and nationally). According to unverified performance data the practice had, as at 22 November 2017, completed mental health care plans for 90% of patients with complex mental health conditions for 2017/18.
-
In 2016/17 the percentage of patients with dementia who had an agreed care plan in place was also now in line with local and national averages (86% compared to CCG and national average of 84%).
-
In 2016/17 the percentage of patients with atrial fibrillation who met specific clinical requirements that were being treated with anticoagulation therapy was now in line with local and national averages (80% compared with 86% of the CCG and national average of 88%).
-
Although we were not provided with any recent complaint response which included contact information for organisations that patients could escalate concerns to, the practice provided a leaflet with this information which we were told was available at reception and on the practice’s website.
-
The percentage of patients who had bowel cancer screening in 2016/17 was in line with local averages (44% compared with 41% in the CCG).
However, there was also an area of practice where the provider needs to make improvements.
The provider should:
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice