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Email sent by Wessex LMCs, on Tuesday, 9 Aug 2016

Date sent: Tuesday 9 August 2016


Please accept my apologies for sending another email so soon after the last newsletter but we are becoming increasingly concerned at some of the issues being raised at CQC inspections, particularly where bank inspectors are being used in an effort to meet CQCs deadline of undertaking an inspection and providing a rating of every practice by the end of 2016.   


I sent three questions to Joanne Ward, Inspection Manager for the Wessex Team South Region at CQC and her responses are shown under each of the three questions: 

Q1. A few practices have been advised that all of their chaperones must have a DBS check even where they’ve been working at the surgery and as a chaperone for many many years. The practices involved have undertaken risk assessments, the staff have undergone training, they’re following their chaperone policy to the letter and we had initially advised that this was OK – has anything changed please?  Incidentally, the inspectors did not want to see the risk assessments or check the policy.

R1. All staff who chaperone need to have a risk assessment to determine need for a DBS and record how the decision was made. The practice policy needs to state the role of the chaperone clearly including how to ensure assessment to be a chaperone, training and specifics of the role requirements. However if they do not have a DBS completed then the role of that chaperone must  include that they leave  the room if the clinician leaves the room. We find most practices do ensure that DBS checks are completed and this is encouraged.


Q2. Again, DBS I’m afraid. Nurse working in the practice for 18 years – no change of job role, risk assessment undertaken and decided no DBS necessary. Inspector said she must have one.

R2. A DBS is needed for all staff if relevant to their role and recruited to their current role since the registration of primary medical services in April 2013. It’s essential the practice has a clear policy and this is also adhered to.


Q3. Prescriptions in printers – a number of practices have been told that they must remove the prescriptions at night even though the individual doors are locked and the contract cleaners have all been DBS checked and assurance/evidence given by their employer. The scripts are all numbered and signed out to each of the GPs surgeries, to remove them every night could cause some mix-ups and seems a bit unnecessary especially when in a few cases there is nowhere more secure to put them.  One practice said their safe isn’t big enough so it would be just another locked room.

R3. The room where the printer is held often the  consulting room, needs to be lockable  and that lock applied when the room is vacated even for short periods.  Tracking the use of the prescriptions is also needed to ensure prescription fraud is not taking place. Where there is concern about access to the room this is normally managed by risk assessment and if any doubt after a risk assessment some  practices do empty printers to a lockable cupboard. This must be clear in their policy. Cleaners can and do have access and this should be risk assessed and checked before having access to that room.


Joanne's responses are in line with long standing LMC advice and she has said she will ensure that bank inspectors are updated - please feel free to present this information to any inspector where appropriate.


With best wishes


Carole Cusack  | Director of Primary Care

Wessex Local Medical Committees Ltd

Phone | 023 8025 3874   Mob I 07825 173327 Fax | 023 8027 6414   

Email |

Address | Churchill House, 122-124 Hursley Road, Chandler's Ford, Eastleigh, SO53 1JB




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Updated on 09 August 2016 1504 views