Case: 202206736
NHS organisation: Alba Medical Group
Subject: GP & GP Practices \ Training/ supervision
Date: January 2025
Summary
The complainant (C) worked as an Advanced Nurse Practitioner (ANP) in one of Alba Medical Group (the Group)’s general practices. C complained to the INWO about:
- the competence, supervision and training arrangements for ANPs recruited from secondary care into primary care at the Group (not upheld)
- consultation by telephone rather than face-to-face created unreasonable risks of harm to some patients (not upheld)
- the Group's handling of the concern in accordance with the National Whistleblowing Standards (the Standards) (upheld)
We investigated and took expert advice. We found that ANPs trained in secondary care were qualified to work in primary care with appropriate support and supervision. We also found that the Group's supervision, support and continuing professional development (CPD) arrangements for ANPs were reasonable, and that ANPs restricted themselves to their areas of competence, whilst developing their competences in primary care.
We also considered work done by the Group to strengthen their recording of ANP competences, in light of C's concerns. We found that the competence sign-off arrangements were reasonable, and we recognised improvements made to the process had been a good outcome from C's initial concerns.
We found that at the time C worked for the Group, the NHS was coming out of the pandemic and the use of telephone consultations in primary care had become normal practice. We took expert advice and we concluded that ANPs consulting with patients over the telephone did not create unreasonable risks. We were also assured that ANPs knew when to bring patients in for face-to-face appointments, if they had concerns. We considered telephone prescribing and did not find any concerns.
We found that some aspects of the Group's concern handling required improvement around confidentiality, awareness of the Standards within the Group, the Group's responsiveness to staff raising concerns, and ensuring the stage 2 decision report contains appropriate information and meets the requirements of the Standards. We made recommendations to address these issues.
Recommendations
What we asked the organisation to do in this case:
- Apologise to C for these failings. The apology should meet the standards set out in the SPSO guidelines on apology available at http://www.spso.org.uk/information-leaflets
In relation to complaints handling, we recommended:
- The Group complies with the National Whistleblowing Standards.