COMMUNICATION between an external healthcare organisation which runs a Herefordshire medical practice and its staff remains a concern for inspectors.

Kington Medical Centre retained its overall rating of 'good' by inspectorate Care Quality Commission during a focused inspection in February.

The visit was made to confirm that the practice had carried out their plan to meet the legal requirements from its previous inspection in November 2015.

Professor Steve Field, Chief Inspector of General Practice, found that significant events had been recorded and he saw evidence of the learning and action that had taken place as a result.

He commented that the practice was aware of the requirement to inform CQC of certain events and had done so following an incident involving the dispensary.

Professor Field commented that a nurse led minor illness walk-in clinic had been introduced following the previous inspection. This service was available for five days a week and was very popular with patients. Patients had praised staff as helpful, caring and professional.

However, he raised concerns over the communication between Integral Medical Holdings, who run the back office at the medical centre and staff at the centre.

Professor Field's report said: "In September 2015 the practice had entered into an arrangement with an external healthcare organisation.

"The intention of this was to stabilise the practice by gaining support with finance, administration, governance and GP recruitment. In November 2015 we found that

communication with the practice team regarding the details of these arrangements had been limited.

"These areas were highlighted following our inspection in 2015. We found that these areas had not been addressed in our inspection in February 2017."

Professor Field said that the provider must ensure that relevant historical information about patients is available for clinicians.

He found that patients’ notes had not been summarised prior to 2003.

Professor Field added: "There was also a risk that incomplete information could be passed to out of hours or to secondary care providers. We discussed this with the providers and they confirmed that immediate action had been taken to add alerts to patient records so that all clinicians were aware that they may need to access additional patient records.

"Clinical staff told us they had taken on additional administrative tasks to help reduce the workload of administrative staff.

"We spoke with clinical and non-clinical staff on the day of the inspection. They told us they were committed to their patients and only wanted to provide the best services they could. They told us they provided excellent clinical care which was confirmed by the patients we spoke with and aligned with the views on three comment cards we


"The lack of GP and nurse clinical meetings meant there was limited formal opportunity to share information, discuss clinical cases and monitor patient care, promote learning, evaluate and monitor skills. Clinical staff told us they needed more time to discuss patient cases more formally."

Following the inspection the provider had confirmed that an action plan had been developed to address and complete summarising of all outstanding and ongoing patient notes. The scheduled date for completion was May 5, 2017.