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Independents' Day

Steve Field's practice rated 'requires improvement' for patient safety

The GP practice where the CQC’s chief inspector of general practice, Professor Steve Field, is a partner has received a rating of ‘requires improvement’ on ensuring services are safe for patients, despite being given a ‘Good’ rating overall.

CQC inspectors said the Bellevue Medical Centre, Birmingham, needed to improve its patient safety after failures to appropriately review patients on high risk medications.

However, the practice was found to be ‘outstanding’ in the ‘responsiveness to people’s needs’ domain, with clinics at a local asylum centre and work with homeless patients highly praised.

The practice is part of Birmingham’s Modality Partnership and the inspection report, published last week, highlights that these partnership changes may have been partly responsible for the safety failings.

Professor Field told Pulse he ‘accepts improvements have been requested’ and that he knows the issues with high risk medicine reviews have ‘already been addressed’.

He added he was particularly pleased that the practice’s work with vulnerable and homeless patients had been recognised.

The inspection comes almost a year after Professor Field told the Daily Mail that the poor care in some practices made him ‘ashamed’ to be a GP, adding that he ‘believe we’ve failed as a profession’.

In the same interview Professor Field was said to be particularly concerned by the fact that 29% of practices were found to be ‘not safe’, including 5% who were found to be ‘inadequate’ on the safety score.

This led to GP leaders calling for his resignation, though his comments were backed by Jeremy Hunt as ‘courageuous’

Bellevue is among the last practices in England to be inspected as the CQC aims to hits its deadline of inspecting and publishing reports for all practices by the end of the year – a deadline that was originally September 2016.

The report states that the practice must take steps to ‘ensure that the systems and processes to address risks associated with high risk medicines are implemented to ensure patients’ safety at all times.’

It states: ‘Although risks to patients who used services were assessed, the systems and processes to address these risks were not always implemented well enough to ensure patients’ safety.

And an audit of anonymised patient records receiving high risk medications highlighted issues, including:

  • Failure to carry out reviews in the last 12 months for ‘105 out of 556 patients’ prescribed a medication for heart failure and high blood pressure. The practice’s subsequent review found 139 patients, though 27 had been seen at another provider, others were due to patients not arranging appointments and in 17 cases due to a ‘form processing failure’.
  • In another case the report states, a medication for treating mood disorders was ‘prescribed for 10 patients and we found that five of these patients had reviews which were overdue’

Aside from the high risk medications issue the report shows the practice is highly regarded amongst patients, with regular input from PPGs and that staff had regular meetings with management, and training.

The areas of outstanding care highlighted include: ‘Care and support provided at a ‘local asylum dispersal centre’, where specialist weekly clinics were provided to build relationships and maintain continuity of care; and work with a faith-based charity ‘distributing meals to homeless people’ and undertaking a project to reduce avoidable deaths due to accidental overdose.

Professor Field said: ‘It is a privilege to continue to see patients as a GP at Bellevue in Birmingham.’

‘It keeps me grounded about the issues of practicing as a GP in a deprived inner-city practice, feeling all of the pressures that GPs are under across the country.’

‘Bellevue has recently merged into the Modality Partnership and is subject to the same scrutiny by CQC as other GP practices. I accept that improvements have been requested and I know they already been addressed.’

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Readers' comments (49)

  • This man and his successors have done more to damage primary care morale than they can imagine! chasing gongs and titles whilst masquerading as one of the team both himself and his direct successor should be consigned to history within the profession. As it is they are hailed as champions of the profession and hence the rot that has set in and terminal decline from which primary care in England will never be able to extricate itself......if you're young and still have a future as a GP , it certainly aint in England, unless you wish to be spoken down to by one of the "old boys" and symbols of antiquity that the college, CQC and other self serving organizations represent

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  • Lolololo ha ha ha!


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  • I have never seen any acknowledgement from him regarding the huge problems that GPs face and that this just could be a mitigating factor in why some practices are seen to fail, according to the seriously flawed CQC appraisal.

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  • So will he resign?

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  • That must have been a difficult conversation!!

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  • Interesting report. Is the CQC 'well led' if its own boss is unable to ensure safe practice yet berates the profession as having 'failed'. Maybe it is in fact the esteeemed Prof who has failed. Time for some reflection methinks.

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  • This is just beautiful. Leave your stethoscope on the desk and go, Prof. Field

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  • High Level feedback at the end of the inspection day must have been interesting experience!

    Especially as have to sign for recipt of the feedback

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