Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Canberra Old Oak Surgery on 29 June 2017. Overall the practice is rated as good. The practice was rated good for providing safe, effective, caring, responsive and well-led services.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• There were effective systems to ensure that all clinicians were up to date with both National Institute for Health and Care Excellence guidelines and other locally agreed guidelines.
• Staff were proactively supported to acquire new skills and had access to appropriate and bespoke training to meet their learning needs and to cover the scope of their work.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. 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 strong and visible clinical and managerial leadership and governance arrangements.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
• The practice used innovative and proactive methods to improve patient outcomes and worked with other local and national healthcare providers to share best practice.

We saw areas of outstanding practice:

• The practice benefited from a corporate business intelligence tool which provided access to bespoke searches relevant to medicines management and effective care. This enabled the practice to readily identify when follow up tests and screening were due in the management of patients with long term conditions and those experiencing poor mental health. The practice demonstrated that the system and continuous patient recall had improved compliance of tests and screening in the eight months they had managed the practice. Data for 2016/17 showed the practice as the second highest achiever in the GP locality network for the nine diabetes key processes, with a 13% improvement since taking over the practice in August 2016.
• Staff had access to a suite of bespoke training materials to cover the scope of their work and meet their learning needs. This included access to a corporate learning and development portfolio featuring face-to-face, web-based and blended training programs tailored for each staff role. For example, fortnightly web-based training for healthcare assistants and nurses’ development support, bi-monthly development for practice management, fortnightly consultant led development program for clinicians and monthly face-to-face training for the physician associate and pharmacist. All staff at the practice, including receptionists undertook annual mandatory training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards.

The areas where the provider should make improvement are:

• Review the effectiveness of storing emergency equipment and medicines in two separate locked locations.
• Review the arrangements in place for when prescriptions issued for collection at the practice or nominated pharmacy are not collected.
• Continue to monitor and act in response to patient feedback including the national GP patient survey findings to drive improvements where applicable.
• Consider highlighting through available resources the bi-lingual skills of staff members.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice