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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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