Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Abbeyview Surgery on 8 October 2015. Overall the practice is rated as Good.

It was good for providing safe, effective, caring, responsive and well-led services.

It was outstanding for providing services to people with long term conditions and people who suffer with mental health including dementia. The practice was good for all the remaining population groups.

Our key findings across all the areas we inspected were as follows:-

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, being a pioneer in Lincolnshire for being a ‘Carer Friendly‘ and ‘Dementia Friendly‘ practice .
• QOF results for 2013/14 were 99.0% of the total number of points available. All data was above CCG and national averages.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw a number of areas of outstanding practice including:

• The practice was a pioneer in Lincolnshire for being a ‘carer friendly‘ and ‘dementia friendly‘ practice . The practice recognised the invaluable and essential role carers play in supporting relatives, friends or neighbours.

• In November 2014 all staff employed by the practice together with members of the patient participation group (PPG) received dementia awareness training. Supporting the vision, the practice had a designated the senior receptionist as the ‘carer champion’ alongside a member of the nursing team assigned as lead contact for patients suffering with dementia and their carers.
• The practice offered Dementia Awareness events to patients registered with the practice and to the people who lived in the community in Crowland and surrounding areas. Their aim was to raise awareness and improve the services offered by the practice to patients with memory impairment and their carers.
• A diabetes seminar was held by the practice on 8 May 2015. Speakers included consultant and specialist doctors and nurses in diabetes care who offered advice on topics including healthy eating (particularly for patients at risk of developing diabetes or diet only controlled), best injection techniques, importance of monitoring for early identification of any developing associated problems. Opportunities were given for patients to ask questions.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

• Ensure NHS Property services carry out a fire risk assessment.
• Review the processes for the recording of near misses and security of medicines in the dispensary
• Ensure a risk assessment is carried out in relation to the two medicine pick up points.

• Within the Business Continuity Plan ensure mitigating risks and actions are included.

• Have in place a schedule of minuted meetings

• Consider undertaking more audits in regard to the quality of the dispensing service.

• Update the cold chain policy to ensure staff have guidance on what action to be taken in the event of a potential failure.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice