Letter from the Chief Inspector of General Practice
We inspected Reading Walk-in Health Centre on 28 January 2015. This was a comprehensive inspection. The service has a registered population as well as providing a walk in service seven days a week to the local population.
We have rated the practice as requires improvement because improvements in the effectiveness and responsiveness are required.
Our key findings were as follows:
The practice provided good care and treatment to their patients. National data showed the practice performed similarly to the national average in managing long term conditions. Patient feedback showed the opening hours were popular with patients and they liked the flexibility this provided. Patients were less positive about their overall ability to make appointments due to phone access and the availability of bookable appointments.
The practice population was expanding rapidly. The practice used tools to monitor and assess the allocation of staff and had made changes to meet the demands on appointments from registered patients. A robust strategic plan was not in place to meet the increasing demands or alleviate the pressure from the registered population. The walk-in access and availability of appointments was monitored regularly and alterations were made to try and improve access. For example, providing less phone consultations to free up more appointment slots. The practice was clean, well maintained and safe. The premises were accessible for patients with limited mobility.
There was a leadership team with clear responsibilities and the day to day management of the service was clearly delegated to enable staff to fulfil their roles. Medicines were checked and stored safely. Staff were aware of the diverse nature of their patients and went to great effort to meet the needs of minority and vulnerable groups. The practice had worked with some specific sections of the local population, such as the Nepalese community. However, not all sections of the local community were considered in the planning of the service. An open and inclusive culture encouraged staff to participate in the running of the practice. The practice has established a patient participation group and three meetings were held in 2014 however the attendance was not good despite posters advertising the meeting being displayed in the waiting areas of the service. The local population was very transient and this may have made creating a PPG difficult. The practice should consider different forms of PPG to help develop this.
There were areas of practice where the provider needs to make improvements.
Importantly, the provider must:
- Continue to assess and monitor the quality of the service, to ensure that patients can access services and there is capacity to meet the demands of the registered patient population and walk-in service, notably the appointment system.
- Address the care, treatment and communication needs of the non-English speaking population.
- Review the system for monitoring referrals before patients are sent to external services and supervise the referrals made by the nurse practitioners.
- Review the repeat prescribing protocol to ensure patients receive medicines they require safely.
In addition the practice should:
- Determine whether improvements can be made at the reception desk to ensure confidentiality is maintained
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice