Eltham Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eltham Medical Practice on 17 May 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Staff had received training on safeguarding children and vulnerable adults relevant to their role. They understood their responsibilities; however, not all staff spoken to were aware of external safeguarding agencies.
• The arrangements for managing medicines, including emergency medicines and vaccines, in the practice had been improved and minimised risks to patient safety. However, we noted that the practice did not stock some of the recommended emergency drugs.
• Fire safety measures at the main site were the responsibility of the building owners. The practice had not considered the potential benefits of periodically reviewing the level of fire safety awareness within their own staff team.
• The practice provided us with two audits completed in the last three years. These showed limited evidence of quality improvement.
• There were panic alarms in all the consultation and treatment rooms which alerted staff to any emergency. There was also an emergency/panic button in the reception area; however we were informed this had not been enabled. The potential risk this posed to staff had not been assessed.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients felt they were treated with compassion, dignity and respect. The practice was comparable to local and national outcomes for its satisfaction scores on consultations with GPs and nurses.
• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
• We noted that there was no effective safety net in place to ensure blood tests arranged by the nurse practitioner were followed up.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns. However, the practice asked that all complaints be made in writing contrary to current regulations.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was comparable to local and national averages.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Review practice emergency arrangements, specifically relating to emergency medicines; fire safety and panic alarms.
• Ensure staff are aware of external safeguarding agencies, and when they might use them.

• The provider should continue to consider the quality of care provided; review the care provided in relation to current best practice guidance; make changes where necessary or appropriate in order to improve and revisit the question to see whether the changes made have resulted in an improvement.
• Review the blood test follow up system used by the nurse practitioner, to minimise the risk to patients that results were not followed up.
• Ensure the complaints process is in line with legislative requirements such as signposting the Ombudsman in the practice’s decision letter, accepting oral complaints and ensuring complainants receive suitable support and advice, or signposting to them.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice