Archived: North Norfolk Primary Care

We carried out an announced comprehensive inspection at North Norfolk Primary Care on 2 September 2019 as part of our inspection programme. This is the first inspection of North Norfolk Primary Care.

North Norfolk Primary Care is a private limited company providing NHS funded care services, including improved access GP appointments and an enhanced care home visiting team, on behalf of the 19 member GP practices in North Norfolk. The provider has a board of directors and each member practice has nominated a GP to hold its shares on the practice’s behalf, governed by its Articles of Association and a Shareholders’ Agreement.

The chief executive officer is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We received 18 comment cards, all of which were wholly positive about the service. Comments included that staff took time to listen to patients and the appointment system was easy to use. The provider had collated feedback given by care homes and practices they supported. They had received nine pieces of feedback which were wholly positive about the service. We spoke with two external stakeholders who used the service and the feedback was positive about the way the provider worked with them. They told us they liaised regularly with their service to ensure patients got the care they needed.

Our key findings were :

• Improved access GP appointments were offered from four GP practices ensuring the service was accessible to all patients across North Norfolk.
• Patients were supported, treated with dignity and respect and were involved in decisions about their care and treatment.
• Patients’ needs were met by the way in which services were organised and delivered.
• Feedback from patients on the day of inspection, including CQC comment cards, was positive about the care received by the provider.
• The service completed audits on the effectiveness of the service.
• Feedback from external stakeholders was positive about the service provided.
• There was a positive culture and staff were enthusiastic and positive about the care they provided.

However, we also found that:

• The leadership, governance and monitoring of risks arrangements of the service did not always ensure the delivery of high-quality care.
• The service could not evidence that all the checks required to employ staff appropriately were in place.
• The service had not implemented effective systems to ensure appropriate and safe provision of emergency medicines and equipment.
• The service did not have assurance that the premises from where they delivered services from were safe for their intended purpose. For example, they did not have oversight of up to date fire safety, health and safety or infection prevention and control risk assessments.
• As a result of feedback given on the day of the inspection, the provider shared with us an action plan to drive the improvements needed.

The areas where the provider must make improvements as they are in breach of regulations are:

Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care