The Care Quality Commission (CQC) inspects every health care provider in England on a regular basis. They undertake a highly rigorous examination, looking at five major aspects of care - is care effective, responsive, caring, well-led, and safe?
Any practice that is rated as 'requires improvement' in 2 or more domains will be rated as 'requires improvement' overall.
Haydock Medical Centre had a routine inspection on 13th June 2019, and the practice was rated as 'requires improvement' on 14th August 2019.
The practice recognizes the importance of the CQC's work in identifying areas for improvement for all healthcare providers. We aim for excellence, and we welcome the feedback as an opportunity to respond and act, and to further develop and improve our systems and our services for patients.
The report noted
• On the day appointments allowed for rapid access
• Fifteen-minute appointments were provided as standard and double appointments were provided when required.
• Patients could book or cancel appointments online and order repeat medication without the need to attend the surgery
• The practice was responsive to the needs of older patients and offered home visits and urgent appointments for those with enhanced needs and complex medical issues
• Babies and young children were offered an appointment as a priority and appointments were available outside of school hours.
• The practice was proactive in offering online services including the booking of appointments and requests for repeat prescriptions.
• Electronic prescribing was also provided.
• The practice provided online consultations, triage, and telephone consultations.
• Priority appointments were allocated when necessary to those experiencing poor mental health.
The report also noted that the practice had made several changes to increase the capacity of the clinical team and to the way in which patients book appointments. These changes included:
• The recruitment of additional GPs and advanced nurse practitioners.
• The provision of same-day appointments. All requests are triaged by a duty GP and allocated to the most appropriate clinician on the day. Almost all patients are seen on the same day, though clinicians have the flexibility to book ahead if required.
• The provision of phone consultations when appropriate
• The provision of extended access.
• The introduction of E-Consult online consultations
• The appointment system was flexible and allowed for a range of urgent and routine appointments and online appointments.
The CQC rated the practice as good for providing a service that is caring, effective and responsive:
• Patients received effective care and treatment that met their needs
• Staff dealt with patients with kindness and respect and involved them in decisions about their care
• The practice organized and delivered services to meet patients’ needs.
• Patients could access care and treatment in a timely way
Our care was rated as good for 6 main groups of people - families, children and young people, working-age people, older people, people with long term conditions, people with poor mental health, and people who are vulnerable.
The practice was rated as 'requires improvement' in the categories of safe and well-led, giving us a rating of 'requires improvement' overall.
In the category of safety, the practice was rated as having met 59 of 66 standards, with partial achievement of a further 6 standards. One standard- 'there was evidence of learning and dissemination of information' - was judged not to have been met.
In the category 'well-led' the practice was rated as having met 26 of 32 standards, with partial achievement of a further 8 standards.
The practice took immediate action to address the specific areas that were identified:
The practice has acted to improve the secure storage of prescriptions to comply with national guidance
A risk assessment by our cleaning company for the storage of cleaning materials has been provided
The practice added details of specifically how to complain to NHS England to our existing complaints leaflet in the waiting room
A specialist health and safety assessment has been booked
Recommendations from a recent fire risk assessment have been actioned and/or reported
The practice acted to improve the documentation of the ongoing supervision and mentoring of nurse clinicians and will, in addition, undertake regular review of their prescribing
The practice acted to improve the recording of national safety alerts in the minutes of team meetings, to document that these have been discussed and to record any action required
The practice has a very longstanding and very active approach to reporting and discussing significant events. However, we acted to improve the documentation of the significant events that we consider and the subsequent sharing of any learning from these. The practice will undertake an annual review to look for any themes and trends
The practice will continue to work to improve systems and processes for managing risks and to operate effective processes to ensure good governance
The practice codes family members for children that are at risk, but has reminded clinicians and staff of the appropriate codes to use