Melrose Surgery, Reading Also known as Melrose Surgery

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The practice had effective systems to assess, monitor and continue to improve the quality and safety of service. There were processes for monitoring patients’ health in relation to the use of medicines including medicines that require regular reviews. However, we reviewed patients’ clinical records and found some patients were overdue monitoring. Following the assessment, evidence was provided that demonstrated that those patients had been contacted for a review of their treatment.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were systems and processes to share information with staff and other agencies to enable them to deliver safe care and treatment. This included regular multidisciplinary meetings between the practice and other health and social care professionals such as health visitors, community midwives and social workers. We saw that the practice was equipped to respond to medical emergencies and staff were suitably trained in emergency procedures.

Practice staff described how care was delivered and reviewed. They told us how care was coordinated when different teams, services or organisations were involved

Patient feedback highlighted there was continuity of care was offered, including when people moved between different services.

The practice adapted their services in response to the feedback received from the partners. The commissioners told us they had no concerns about the practice.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

During the site visit, we saw the practice had systems for the appropriate and safe use of medicines, including medicines optimisation. For example, the practice had taken steps to ensure appropriate antimicrobial use to optimise patient outcomes and reduce the risk of adverse events and antimicrobial resistance. Prescribing data for the practice demonstrated positive variation when compared to national averages. However, some improvements were required, for example, we saw there was an inconsistent process to manage Patient Group Directions and emergency gases, specifically oxygen. The practice immediately acted on our feedback, made the required improvements, and implemented a system to ensure the improvements would be sustained.

The practice provided GP services to 2 local care homes. The managers from both care homes told us that the practice was responsive in meeting the needs and preferences of their residents. This included how medicines were managed between the practice and the care homes.

We reviewed clinical records for patients who had been prescribed medicines which required routine monitoring. This included patients’ records who had been prescribed DMARDs (a disease modifying antirheumatic drug used to treat pain). Our search reviewed 3 patient records and found that 1 of 3 patients had been monitored and reviewed in line with current clinical guidelines. The searches of patients prescribed the high-risk drug Angiotensin converting enzyme (ACE) inhibitor or Angiotensin II receptor blocker (used to treat high blood pressure) identified 2 patients were overdue a blood monitoring test and weight measurement. The practice was responsive and promptly acted on the concerns found through our searches.

The practice had processes to manage medicines. These processes reflected current and relevant best practice and professional guidance. Patients prescribed high-risk medicines that required regular monitoring in most cases had their reviews completed according to best practice guidance. There was however no process for formal clinical supervision for non-medical prescribers. The provider could not demonstrate they were doing their own prescribing audits or reviews of consultations to ensure appropriate prescribing following current best practice guidelines was taking place. Once highlighted, the provider implemented a new process and aligned policy to support the non-medical prescribers. The new process included a self-assessment, reflection, and audit of prescribing practice against the 10 recognised prescribing competency criteria.

The leaders at the were all aware of their roles and responsibilities surrounding medicines management. For example, the clinical pharmacist was responsible for following up patients with a long-term condition, who had received treatment in hospital or through out of hours services. We saw the practice had a written protocol for repeat prescribing of medicines which specified the monitoring needed.