Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Linden Medical Group on 27 March 2015. Overall the practice is rated as requires improvement.
Specifically, we found the practice to require improvement for providing safe, responsive and well-led services. It also required improvement for providing services for all the population groups we inspected. It was good for providing an effective and caring service.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, appropriately reviewed and addressed on most occasions.
- Recruitment checks and risk assessments linked to chaperone duties were not adequate and needed to improve.
- Performance data showed patient outcomes were in line or below the local and national averages. We saw that clinical audits had been carried out and this was driving improvements in performance to improve patient outcomes.
- Patients said they were treated with compassion, dignity and respect.
- Patients said improvements had been made to the phone access and urgent appointments were usually available on the day they were requested. However, data reviewed and patient feedback showed patients sometimes had to wait a long time for non-urgent appointments and continuity of care was not always maintained.
- Information about how to complain was not easily available to patients. Systems in place for documenting complaints received, investigations undertaken, responses provided to patients and shared learning with staff required strengthening to reflect appropriate complaint handling.
- There was a clear leadership structure but the governance structure needed strengthening to ensure the systems to enable the providers to assess and monitor the quality of the service and identify, assess and mitigate risks were effective.
The areas where the provider must make improvements are:
- Ensure all staff records include necessary employment checks stipulated in Schedule 3 (Information Required in Respect of persons seeking to carry on, manage or work for the purposes of carrying on, a regulated activity).
- Ensure the complaints process is well publicised and brought to the attention of patients, visitors and staff in a suitable manner and format, and suitable records are kept to reflect established principles of good complaint handling and shared learning with staff.
- Ensure governance arrangements in place including systems for assessing and monitoring risks and the quality of the service provision are strengthened. This includes secure storage of confidential personal information and blank prescriptions.
In addition the provider should
- Improve the phone access, availability of non-urgent appointments, waiting time for appointments and continuity of care.
- Take more proactive steps to ensure patients with a learning disability have an annual health check.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice