Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Central Surgery on 5 April 2016. Overall the practice is rated as good.

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.

• Risks to patients were assessed and well managed.

• Outcomes for patients who use services were good.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice had a system in place for handling complaints and concerns and responded quickly to any complaints.

• Patients said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.

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

• There was a clear leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.

• Staff throughout the practice worked well together as a team.

• The practice carried out a survey of staff in January 2016 using the CQC key questions.

• The practice was aware of and complied with the requirements of the duty of candour.

• The practice were innovative and moving towards further improvements to elderly care, young people and promoting self-care.

We saw one area of outstanding practice which included:

• The practice were one of the leading practices in the area for providing a substance misuse service to patients. One of the GP partners had a clinical interest in this area and was the lead on this for the practice with two other GPs, a recovery worker and an administrative member of staff and the practice pharmacist. The practice had 51 patients they provided opiate substitute medication to and 35 who were in GP shared care. The practice had carried out a repeat audit on substance misuse patients attending for review. The purpose was to set goals for reviews and to review prescribing with set review appointments as it was felt that this group of patient struggled to access appointments appropriately. They also wanted to ensure they were receiving the appropriate support. The criteria was set for 80% of all of the patients to be reviewed every year. The findings of the re-audit found that 88% of the patients had been seen by their GP at three month review stage rather than twelve month stage (previously 49%). The practice also implemented regular meetings to discuss these patients and encouraged them to have a named GP to deal with individual prescriptions.

The areas where the provider should make improvements are:

• Consider specific training for the infection control lead nurse and carry out a more comprehensive infection control audit.
• Consider carrying out a risk assessment as to why some administration staff did not have a DBS check.
• Consider a risk assessment around the emergency medicines which were available in the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice