Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bull Farm Surgery on 22 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. Lessons were shared to make sure action was taken to improve safety in the practice.

• 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.

• Patient survey figures showed patients rated the practice higher than others for most aspects of care. Comments about the practice and staff were positive.

• 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 practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice had employed an advanced nurse practitioner so that the GP’s were able to spend more time with more complex patients.

• 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.

• Safety alerts and alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and cascaded to the appropriate persons. However we did not see these discussed in clinical meeting minutes.

• There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular meetings. Meetings did not show standing agenda items such as complaints, patient safety alerts and NICE guidance.

• The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active.

• The practice had identified 39 patients as carers (1.4% of the practice list).

The areas where the provider should make improvement are:

• Review process and methods for identification of carers and the system for recording this. To enable support and advice to be offered to those that require it.

• Implement a continuous programme of quality improvement including clinical audit.

• Update action plans accordingly to evidence completed actions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice