28 July 2015
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Rina Miah (Harbottle surgery) on 28 July 2015. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses. However, assessments had not been carried out in relation to all risks to the safety of patients and staff;
- Overall, the main practice and its branch surgeries had good facilities and were well equipped to treat patients and meet their needs. However, the absence of a defibrillator and oxygen supply at the Otterburn surgery could make it difficult to provide emergency treatment to patients should they become seriously ill at the surgery;
- Most systems and processes for managing medicines were satisfactory. However, the practice had failed to make sure that prescription forms were always stored at the Otterburn surgery in accordance with national guidance;
- Information about how to complain was available and easy to understand;
- Most patients told us they were treated with compassion, dignity and respect and were involved in making decisions about their care and treatment. Information was provided to help patients understand the care available to them;
- The practice worked closely with other organisations to help deliver a wider range of services so they could better meet the needs of patients who lived in a rural, isolated setting and who were dispersed over a large geographical area;
- Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received most of the training appropriate to their roles, although we did identify some gaps;
- Results from the National GP Patient Survey of the practice, published in July 2015, showed that patient satisfaction with access to care and treatment was higher when compared to local and national averages. The majority of patients we spoke to on the day of the inspection, as well as those who completed Care Quality Commission (CQC) comment cards and contacted us before the inspection, were satisfied with access to appointments.
The areas where the provider should make improvements are:
- Ensure prescription forms are always stored in accordance with the national guidance;
- Carry out a risk assessment to assess any potential risks to staff when they are working by themselves, and take action to put appropriate support systems in place where these are needed;
- Carry out a review of the systems for delivering medicines to designated ‘pick up’ points to ensure they are safe and secure, including the carrying out of a risk assessment to identify and manage areas of risk associated with this.
We saw an area of outstanding practice:
Results from the National GP Patient Survey showed most patients were happy with how they were treated and the quality of the care and treatment they received. Patient satisfaction scores for GP and nurse consultations were above the local CCG and national averages. For example:
- 99% of patients said the GP was good at listening to them, compared to the local CCG average of 91% and the national average of 89%;
- 100% said the GP gave them enough time, compared to the local CCG average of 89% and the national average of 87%;
- 100% said they had confidence and trust in the last GP they saw, compared to the local CCG average of 96% and the national average of 95%;
- 99% said the last GP they spoke to was good at treating them with care and concern, compared to the local CCG average of 88% and the national average of 85%.
We are aware that since the inspection NHS England have terminated the contract and surgery has been closed. Had the surgery continue to function it may have been subject to a requirement notice with respect to the security arrangements for blank prescription pads at the branch surgery at Otterburn.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice