Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Acre Surgery on 20 December 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The majority of patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had adequate facilities and was well equipped to treat patients and meet their needs.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

We saw evidence that the partners drove continuous improvement and staff were motivated to participate in change. There was a clear proactive approach to seeking out and embedding new ways of delivering the service. For example, the practice participated in Productive General Practice (PGP), an organisation-wide change programme, developed by the NHS Institute for Innovation and Improvement which supports general practices to promote internal efficiencies, while maintaining quality of care. The practice had analysed and process-mapped existing processes such as patient registration, prescription requests chronic disease monitoring and made changes and efficiencies. For example, enabling the practice to align blood tests due for different chronic conditions and link this to the repeat prescription process. In addition the practice organised annual external facilitator-led team retreats which focused on enhancing the efficiency of the practice, improving patient satisfaction and optimising staff teamwork and collaboration. Staff commented positively on the value of the retreat in a post-event survey.

The areas where the provider should make improvement are:

• In carrying out regular checks of emergency equipment record which items have been checked.
• Continue to review national GP patient survey data to identify and implement areas for improvement.
• Engage more directly with the Patient Participation Group (PPG) and promote its activities to encourage wider patient membership.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This inspection visit was carried out in response to anonymous concerns received about poor patient care at the service. We spoke to the practice manager, a practice nurse and three patients during our visit.

We found that patients were involved in decision making about their care and treatment and consulted about their experiences of the service. Patients were provided with information about a range of conditions and support available to them at the practice and through external agencies.

Patients told us that staff were polite and courteous and we observed staff dealing with patients in a respectful manner. The surgery had taken steps to ensure they were able to meet the needs of the diverse local community.

Patients' needs were assessed and met. Patients told us that they were always able to get an appointment and the practice manager was able to demonstrate how the appointments system had been changed following comments from patients.

Patients received ongoing care and treatment that was regularly reviewed to ensure their needs continued to be met. Health promotion advice and support was also provided to encourage patients to live a healthy lifestyle and improve their quality of life.

Systems were in place to ensure the surgery was equipped to deal with foreseeable medical emergencies.