Letter from the Chief Inspector of General Practice
On 25 August 2016 we carried out a comprehensive inspection at Dr D A Williams & Partners. Overall the practice was rated as requires improvement. The practice was found to be good in providing effective and caring services. However, they required improvement in providing safe, responsive and well-led services.
A requirement notice was issued to the provider for safe care and treatment and poor governance. The concerns related to infection control audits that were not in line with guidance, the system for acting on patient safety and medicine alerts was not effective, the learning from significant events was not routinely being discussed and learning had not been embedded into practice procedures and the practice did not have a system of quality improvement in place to assess and monitor the services provided or to act on high exception reporting. The full report for the August 2016 inspection can be found by selecting the ‘all reports’ link for Dr D A Williams & Partners on our website at www.cqc.org.uk.
As a result, we carried out a focused inspection of the practice on 15 June 2017 to establish whether the required improvements had been met. We found adequate improvements had been made; overall the practice is rated as good.
Our key findings across all areas we inspected were as follows:
- The practice had reviewed their data from the national GP patient survey and acted on patient suggestions to improve patient satisfaction.
- The practice had appropriate policies and procedures in place that were reviewed annually.
- The patients we spoke with on the day of the inspection said they found it difficult to book an appointment and contact the practice by telephone. However the practice had reviewed their telephone system to help improve patient satisfaction.
- The practice had worked with their participation group to make improvements related to patient feedback.
- Staff understood their roles and responsibilities and how these contributed directly to improving patient experiences of the service and the practices performance.
- The practice had conducted an infection control audit which was monitored by the infection control lead who had received adequate training to carry out the role.
- Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) were accessible to relevant staff members and in line with national guidance.
- The system for managing patient safety and medicine alerts was effective, appropriate action was taken and recorded.
- The governance at the practice ensured that risks to patients and staff were identified and mitigated.
- Exception reporting was assessed and monitored to improve performance.
- Significant events were cascade to all staff members however learning from such events were not always documented.
- The practice had identified 87 patients as a carer which was 0.5% of their patient list.
- The business continuity plan was up to date and reviewed regularly.
- Prescription forms for use in computers were recorded and tracked through the practice, however individual prescription pads were not being tracked.
- All non-clinical staff received safeguarding training for children and vulnerable adults.
- Staff were aware of patient confidentiality during private conversations.
Action the service SHOULD take to improve:
- Continue to monitor and act upon patient satisfaction data.
- Review process and methods for identification of carers and the system for recording this to enable support and advice to be offered to those that require it.
- Ensure blank prescriptions are tracked in accordance with national guidance.
- Ensure that the learning from significant events is recorded.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice