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Elmdene doctors' surgery in Greenhithe in rated 'inadequate' and put in special measures

A doctors' surgery has been placed under special measures after inspectors discovered medicine was being stored incorrectly.

Elmdene Surgery, which also incorporates Bean Surgery and Bennett Way Surgery, was rated inadequate by the Care Quality Commission (CQC) as a result of its latest inspection.

Run by former chairman of Dartford, Gravesham and Swanley Clinical Commissioning Group, which is responsible for all the GP surgeries in the area, Dr Bhaskar Bora and Dr Snajit Shanker Shetty, a recent report published by the CQC has raised concerns with lots of different areas of the surgery.

Elmdene Surgery on London Road, Greenhithe. Picture: Google Street View
Elmdene Surgery on London Road, Greenhithe. Picture: Google Street View

The annual check revealed that a number of medicines had been stored in the wrong way, with there being multiple incidents where the maximum temperature for safe storage was exceeded. This can damage the drugs and compromise their effectiveness.

Inspectors also discovered that there had been an incident in which a patient was given the incorrect tablets at the Bean Surgery dispensary, on Beacon Drive, Greenhithe.

A report published by the CQC explained that a member of staff alerted assessors of the recent dispensing error as there wasn't any record of it happening and it had not been raised as a 'significant event' by the surgery.

It was also found that medicines at the pharmacy were not always double checked by a second person.

The staff rota at the surgery showed that the out of the five sessions the dispensary was open each week, at least one day a week a dispenser would work completely alone in the surgery, for four sessions they worked single handed and for one of those there would not be a GP or nurse in the building.

CQC wrote that this meant staff had no one to check the safe issuing of medicines with or to seek guidance from if concerned.

DETAILS: Chairman of the Dartford, Gravesham and Swanley Clinical Commissioning Group, Dr Bhaskar BoraSLUG: bora gmWHERE: GravesendCONTACT: John Nurden, 03000 424369PHOTOGRAPHER: UnknownCOPYRIGHT: Permission of the Kent and Medway Commissioning Support media team to useKM GROUP USE ONLY FM2609124 (4254494)
DETAILS: Chairman of the Dartford, Gravesham and Swanley Clinical Commissioning Group, Dr Bhaskar BoraSLUG: bora gmWHERE: GravesendCONTACT: John Nurden, 03000 424369PHOTOGRAPHER: UnknownCOPYRIGHT: Permission of the Kent and Medway Commissioning Support media team to useKM GROUP USE ONLY FM2609124 (4254494)

Another issue pulled up by inspectors was that there was no system for the management of emergency drugs in place.

At the Elmdene Surgery, on London Road, Greenhithe, there were a number of emergency medicines not available, such as morphine and an injection used to treat anaphylactic shock.

Deputy chief inspector of general practice and dentistry in CQC’s south region Ruth Rankine said: “It is important that the people who are registered with this practice can rely on getting the high quality care which everyone is entitled to receive from their GP.

“Inspectors found this service was failing to provide the level of care people should be able to expect.

“We found a number of concerns at this service and as a result of our findings they have been rated Inadequate and placed into special measures.

“We will continue to monitor this practice and we will inspect again in six months to check whether improvements have been made. I am hopeful that this practice will do what is required for the sake of their patients, but if we find that this service remain Inadequate, we will consider taking further action.”

The provision of emergency equipment was also a cause for concern, with the Elmdene site being the only one with an automated defibrillator.

"The surgery operates in very challenging situations, while battling with a shortage of GPs and a significant increase in administrative duties for GPs, as well as the administrative staff..." - Elmdene Surgery statement

Inspectors were told that this was due to the other sites being close to Darenth Valley Hospital.

Both the Bean and Bennett Way sites are around two miles away between six and eight minutes drive without traffic from the hospital. The report states 'this would reduce a patient's potential of receiving timely life critical access to emergency provision.'

Another area of concern for the CQC was the surgery's infection control. They noted that there was a patch of corrosion on the surface of the nurse work station at the Elmdene site, a hole in the wall in a treatment room, a toilet seat which was split in half at the Bean Surgery and there were open bins in the treatment room and toilet at Elmdene.

There has been no practice manager in post for two years across the three surgeries. Dr Bora has been the lead partner GP, working ten clinical sessions a week across the three sites and two others, whilst also acting as manager of the practice.

Overall the report rated the practice as inadequate in keeping the services safe, being well-led and effective and CQC said it requires improvement in being caring and responsive.

A statement from Elmdene Surgery said: "Elmdene surgery team has reviewed the CQC report very carefully and has taken immediate steps to improve the services, as per the CQC recommendations. We are awaiting a further inspection shortly.

"The surgery operates in very challenging situations, while battling with a shortage of GPs and a significant increase in administrative duties for GPs, as well as the administrative staff.

"The lack of physical space because of the size of the building has added to the challenges.

"We would like to take the opportunity to thank the various authorities for their continuous support in helping the surgery dealing with complex issues."


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