Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bradgate Surgery on 3 March 2015. Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing safe, responsive , effective, well led and caring services and outstanding for well led. It was also outstanding for providing services for the all the 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. 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.
• 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 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.

We saw several areas of outstanding practice including:

• The practice had established integrated working with a regular morning meeting to which any attached healthcare professional could go and had established joint visits with community staff. There was a direct telephone line to the practice for healthcare professionals to access support and advice. The practice also hosted services such as drug and alcohol rehabilitation and mental health services so patients could receive treatment in their own locality; and held joint sessions with health visitors outside the practice for parents with young children to educate and promote awareness of child care and child health issues.
• The practice worked with other community groups for the health and well-being of the practice population and held open access meetings at community meetings. The practice contributed and were part of the community health plan.
• There was shared learning with other practices as the practice manager was seconded to another practice to establish systems of working which benefitted patients.
• The practice is involved in a pilot for email consultation which will increase access for patients to medical consultation. Also they currently access the tele-dermatology system to expedite dermatology consultation for patients.
• We found Bradgate Surgery was the first practice in Bristol to be given a young people friendly award. ‘Young people friendly’ is an NHS initiative that aims to encourage young people to feel more confident in using health services and to get the award, services needed to demonstrate that they were welcoming to all young people aged 11-19.

• The practice demonstrated a strong commitment to seeking and listening to patient views. Throughout the inspection they demonstrated how patient views had influenced improvements in patient care and service. They showed us a range of evidence (such as patient feedback and complaints) they had used to focus improvements on the needs and wishes of patients. This included celebrating what had gone well as well as identifying areas for improvement.

• The leadership, governance and culture within the practice were used to drive and improve the delivery of high-quality person-centred care. The practice performed consistently well against a number of key indicators, and were able to demonstrate year on year improvement.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as outstanding overall. (Previous inspection 3 March 2015 – Outstanding)

The key questions are rated as:

Are services safe? – Outstanding

Are services effective? – Outstanding

Are services caring? – Outstanding

Are services responsive? – Outstanding

Are services well-led? - Outstanding

We carried out an announced inspection at Bradgate Surgery on 25 April 2018 as part of our inspection programme.

At this inspection we found:

• The provider’s strategy and supporting objectives for the practice were challenging and innovative, working with partners to develop integrated care services and a seven day primary care service.
• The practice had a clear and strong management structure. GP partners at the practice had a history of initiating and developing new ways of working.
• There was clear documentation which showed that new developments had been fully researched and discussed by the practice before implementation, with targets sets, which were later reviewed to ensure the new development was delivering the anticipated benefits.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• By taking part in research, the practice had identified new ways to use technology to improve the quality of care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice