Farnham Integrated Care Services

Updated 11 March 2020

Farnham Integrated Care Services (FICS) is a federation of five NHS GP services from the Farnham area of Surrey. FICS is part of North East Hampshire and Farnham Clinical Commissioning Group.

FICS provides a same day appointment service (for GP and Advanced Nurse Practitioner appointments) to patients from three of the GP practices from 8am to 6.30pm Monday to Friday. In addition, they offer an improved access service (extended hours for routine appointments) for all five GP practices from 6.30pm to 8pm Monday to Friday and 9am to 12pm on Saturdays. The provider also offers a pro-active care management service, a paramedic home visiting service, an integrated care service and a referral management service.

The provider registered with the Care Quality Commission in June 2017 to provide the following regulated activities; Treatment of disease, disorder or injury, Surgical procedures, Diagnostic and screening procedures and Maternity and midwifery services.

Services and regulated activities are provided by Farnham Integrated Care Services Ltd from: Farnham Centre for Health (also known as Farnham Hospital), Hale Road, Farnham, Surrey, GU9 9QS.

The service has a Practice Manager representative from each of the five GP practices within the federation and four FICS directors for the service. There is a service manager, a proactive care lead, two paramedic practitioners, two healthcare assistants and three receptionists. Other staff who provide the same day and improved access services are sourced from the five GP practices on a rota basis. This includes GPs and nurses.

Updated 11 March 2020

The service is rated as Good overall and Good for providing safe services.

We carried out a comprehensive inspection of Farnham Integrated Care Services (FICS) in July 2019. Following this inspection, we rated the service as good overall, but requires improvement for providing safe services as we found concerns relating to the monitoring and tracking of blank prescription stationery and issues relating to the monitoring of fridge temperature checks and escalation processes.

We carried out a focused inspection of the service on 13 February 2020 to follow up on these concerns. We also followed up on areas where the service was not always following best practice standards.

Farnham Integrated Care Services is a federation of five NHS GP services. They provide support and additional services to the patients registered with these practices.

One of the GPs 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.

Our key findings were:

• Blank prescription security had been improved and we saw evidence of tracking processes.
• The January 2019 intercollegiate guidance for child safeguarding had been embedded in the service policy and all staff had been trained to the appropriate level.
• Gaps in recruitment files had been reviewed and systems put in place to ensure these were checked as part of the recruitment process.
• The system for reviewing patient safety and medicines alerts had been improved and the provider ensured all relevant staff were informed when they were received.
• Fridge temperature checking logs had improved, although we noted there were repeat measurements noted over several days in the last two months, which may indicate non-compliance with re-setting procedures. There had been one episode of the fridge going out of the recommended range which had not been escalated using the appropriate process.

In addition to the areas above, we reviewed how the service monitored consent seeking processes. The provider showed us a consent audit which had reviewed patient records where formal consent had been gained. The consent forms used had been adopted from a local hospital trust and the provider had deemed they were in line with legislation and guidance for seeking consent. The service computer systems had an informed consent prompt which could not be bypassed when updating patient records.

Whilst there were no breaches of regulation, the provider should:

• Implement a review of the fridge temperature re-setting process to ensure it is being undertaken correctly.
• Inform staff of the appropriate escalation processes if the fridge temperature goes out of the recommended range (including the minimum and maximum temperatures recorded).

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care