This practice is rated as Good overall. (Previous rating: March 2017 – Good)
We carried out an announced comprehensive inspection at GP Direct on1 June 2016. The overall rating for the practice was good with a rating of requires improvement in the Safe domain. The full comprehensive reports on the June 2016 can be found by selecting the ‘all reports’ link for GP Direct on our website at cqc.org.uk.
This inspection was an announced follow up comprehensive inspection carried out on 9 August 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 1 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection. Overall the practice is now rated as Good.
The key questions at this inspection are rated as:
Are services safe? – Requires Improvement
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
At this inspection we found:
- Some risks to patients were assessed and well managed, except for those relating to medicines management, health and safety risk assessments.
- When incidents did happen, the practice learned from them and improved their processes.
- The practice routinely reviewed the appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
- The practice had modern, purpose built facilities which had recently undergone extensive improvement and refurbishment. The new premises were well equipped to treat patients and meet their needs.
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The practices GP patient survey results were above local and national averages for questions relating to kindness, respect and compassion.
- Patients found the appointment system easy to use and reported that they could access care when they needed it.
- The practice was very engaged with technological developments which aimed to improve the patient journey, which they could share with other practices.
- There was a strong focus on continuous learning and development at all levels of the organisation. The practice used innovative and proactive methods to assure effective communications across the organisation.
- Staff at all levels of the organisation had access to a suite of bespoke training materials to cover the scope of their work and meet their learning needs.
- The practice used innovative and proactive methods to improve patient outcomes and worked with other local and national healthcare providers to share best practice. This included arranged events such as a health and fitness day, the walking group and patient research.
- The practice had strong visible and clinical and non-clinical managerial leadership arrangements.
We saw some areas of outstanding practice:
- The lead GP set up a Sunday morning walking group in the local park in July 2016, which encouraged patients to exercise. The walking group was open to all Harrow residents, was advertised through different channels such as the journal and website and featured in the local paper. The walking group had an attendance rate of approximately 30 patients and was usually followed by a short medical related talk from the lead GP or local hospital consultants. A survey was carried out in August 2018 on 24 patients who attended the walking group and results showed that 100% of the patients felt it was important and 84% reported some or significant benefits from undertaking the walk. 100% of patients would recommend the walking group to family and friends.
- The practice had an agreement to carry out intrauterine device (IUD) fittings for their local family planning clinic. They would provide a spill over service to offer the clinic support to meet their turnaround times for IUD fittings. This ensured that ensured patients were seen in a timely manner. The service had run successfully since its inception in May 2018, with around 60 patients being seen at the practice. They created efficient systems such as a bypass number, to allow for an easy booking process between the family planning centre and there was co-ordinated use of the Emis Web to allow for registration of patients and text message reminders in advance of their appointment. 100% of the 24 patients who completed the Friends and Family test said they would recommend this service to friends and family.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way for patients.
The areas where the provider should make improvements are:
- Take action to ensure all the actions arising from risk assessments are recorded.
- Take action to carry out NHS health checks for patients aged 40-74.
- Improve the recording of complaint responses to ensure the ombudsman details are always included.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.