We carried out an announced comprehensive inspection at Barbly Surgery on 28 February 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We rated the practice as requires improvement for providing safe services because:

• There were gaps in safety systems. This was in relation to single use equipment checks, health and safety, high-risk medicines.

We rated the practice as good for providing effective, caring, responsive and well-led services because:

• Patients received effective care and treatment that met their needs.
• The practice had a comprehensive programme of quality improvement and used information about care and treatment to make improvements.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice promoted the delivery of high-quality, person-centre care.
• The practice had a strong visible and managerial leadership and a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements are:

• Ensure that care and treatment is provided in a safe way.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Review significant events policy to ensure all events are recorded as per the policy.
• Monitor that non-clinical staff are aware of sepsis red flags and the actions to take in the event of a sharps injury.
• Monitor vaccines fridge to ensure that old vaccines stock is not mixed with new stock.
• Develop a system to check that relevant staff have read safety alerts.
• Take action to analyse learning from complaints received.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Barlby Surgery on 15 July 2015 Overall the practice is rated as outstanding.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example they had teamed up with a local charity to deliver a range of health projects in the local community.
• 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 they met 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. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• The practice had increased the flexibility of access to appointments and could demonstrate the impact of this by reduced use of the GP appointments during the day. The practice provided Skype consultations twice weekly, offering approximately 12 consultations per week and there was a GP who was based at the reception desk who provided both telephone consultations and a triage service. The practice was open from 8.00am to 9pm Mondays to Friday and 9am to 5pm on Saturday and Sundays

• The practice had formed a partnership with a local charity to provide a multi-stranded approach to work on health access to primary care services for BME people for whom English was not a first language. The practice had co-produced a short film with patients, clinicians and faith groups called “Talking from the heart” exploring mental health diagnosis and therapy by combining medical and faith advice

• The practice had “Practice Champions” which was a project aimed at parents and children and young people aged 16-21. The Practice Champions supported other patients through education, signposting and peer support. This had increased the amount of young people who attended the surgery for both general information and specific concerns.

• The chief executive sent all staff a weekly ‘staff matters’ bulletin by email. This provided them with any information about the practice including staffing matters, training opportunities, and any changes within the practice group.

• They had developed two training packages. One for clinicians, which entailed fortnightly consultant-led training for GPs via webinars in a collaborative learning environment designed to enhance clinical knowledge and delivering excellent patient services and another for receptionists training as Healthcare Assistants (HCAs). The training was used by other local practices.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice