Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Buxton Medical Practice on 27 October 2015. Overall the practice is rated as good.

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 to report incidents. Information about safety was recorded, monitored, and appropriately reviewed. Learning was applied from events to enhance future service delivery.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. This was kept under review by the practice which proactively used audit as a way of ensuring that patients received safe and effective care.
• Risks to patients were assessed and well managed. Regular liaison meetings were held with the wider multi-disciplinary team to co-ordinate the provision of effective and responsive care. There was good evidence of collaborative working including end of life care and safeguarding. The CCG pharmacist attached to the practice provided regular and effective support on medication issues.

• All members of the practice team had received an annual appraisal and had undertaken training appropriate to their roles, with any further training needs identified and supported by the practice.
• Results from the national GP survey, and responses to our conversations with patients showed that patients were treated with compassion, dignity and respect, and that they were involved in their care and decisions about their treatment.

• The practice worked closely with other services and organisations in the locality, and across the CCG area to plan and review how services were provided to ensure that they met people’s needs.

• Urgent appointments were available on the day they were requested. However, patients said that they sometimes had to wait a long time for non-urgent appointments.
• There was a clear leadership structure and staff felt supported by management.

• The practice proactively sought feedback from patients, which it acted upon. For example, the practice undertook patient surveys and encouraged ongoing feedback via the use of a suggestion box. The practice implemented changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG). For example, the practice had automatic entrance doors which had been raised as an issue by the PPG.
• The practice had introduced the role of advanced nurse practitioners (ANPs) as a response to challenges with GP recruitment and to ensure a wider skill mix to give more flexibility in how services were delivered.

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

Importantly the provider should:

• Implement a review of the practice’s cleaning schedules to incorporate all areas used by patients.
• Implement a review of the storage and management of paper prescriptions in the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice