Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Barnoldswick Medical Practice on 22 March 2016. Overall the practice is rated as requires improvement.
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. However, learning from incidents was not shared with all staff.
- Risks to patients were not always adequately identified and managed, for example there was only evidence of identity checks in one personnel file; emergency equipment was stored in different locations and some patient identifiable data was found in an unlocked bin outside the practice during the inspection.
- Data showed patient outcomes were generally in line with local and national averages.
- Although some audits had been carried out, the evidence did not clearly show that audits were driving improvement in performance to improve patient outcomes.
- Patients said they were treated with compassion, dignity and respect, and told us they were able to get appointments when they needed.
- Urgent appointments were available on the day they were requested.
- The practice had proactively sought feedback from patients and had an active patient participation group.
The areas where the provider must make improvements are:
Improve the governance framework to support the delivery of the strategy and good quality care. This includes arrangements to monitor and improve quality and identify risks. Specifically, the provider must:
- Conduct a risk assessment on the need for controlled drugs being stored within the practice and ensure they are stored securely.
- Ensure patient medical records are consistently updated to include all relevant clinical information including clinical test results from secondary care.
- Ensure patient identifiable information is stored and disposed of securely in line with the requirements of the Data Protection Act 1988.
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Ensure there is an auditable record of all communication with health visitors.
- Carry out a legionella risk assessment and ensure an appropriate legionella control regime is implemented.
In addition the provider should:
- Review the recruitment process to ensure that personnel records include evidence that identity checks have been carried out.
- Provide staff with appropriate up to date policies and training to carry out their roles in a safe and effective manner.
- Discuss significant events with the wider team to ensure learning is shared throughout the practice.
- Review the use of clinical audit to actively improve patient outcomes through regular audit.
- Review the storage of and access to emergency equipment and medication.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice