We carried out an announced focused inspection at Haydon Bridge and Allendale Medical Practice, on 29 April 2019. This was part of our ongoing inspection programme, but we also wanted to check the practice had made the improvements we said they should, when we last inspected the practice in September 2018.
At the last inspection, on September 2018, we rated the practice as requires improvement for providing safe services and issued a requirement notice because:
- The provider did not have an effective system in place for monitoring the prescribing of high-risk medicines.
- The arrangements for maintaining the ‘cold-chain’ for vaccines stored at the practice were not effective.
At this inspection, we found that the provider had satisfactorily addressed these areas. However, they should improve the consistency of recording refrigeration temperatures at the branch surgery.
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 rated this practice as good overall. (Previous rating September 2018 – Good).
We rated the practice as good for providing safe services because:
- The practice had improved the way they monitored the health of patients prescribed high-risk medicines.
- They had improved their systems for maintaining the ‘cold-chain’ for vaccines stored at the practice. (The cold-chain is a system of storing and transporting vaccines at the recommended temperature, from the point of manufacture to the point of use.)
At our previous inspection, we identified there were areas where the provider should make improvements. During this inspection we found the provider had addressed most of the improvements we asked them to make. The provider had:
- Taken action to familiarise staff with the practice’s business continuity plan and business continuity arrangements.
- Introduced a planned schedule of clinical audit and quality improvement activity, for 2019/2020.
- Devised a protocol and a recording tool, to improve their arrangements for monitoring the contents of the doctors’ home visit bags.
- Reviewed the stock of emergency medicines they held at both sites to reflect best practice guidance. They had also improved the way these were stored, accessed and monitored. An appropriate range of emergency medicines were available and reflected the provider’s assessment of what they needed.
- Advertised the availability of pre-bookable, extended access appointments as part of the Hadrian Extra Care Hub arrangements.
The provider had chosen not to maintain an in-house record of staff’s immunity status, as this was an activity carried out by their parent body, Northumbria Healthcare NHS Foundation Trust. (Please refer to our evidence table.)
However, there were also areas of practice where the provider needs to make improvements. Importantly, the provider should:
- Record the temperature of the vaccine refrigerators twice daily, as stipulated in the provider’s policy, and should consistently record what action is taken if the temperature of a refrigerator operates outside of the recommended temperature range.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care