Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Church Walk Surgery on 25 August 2015. Overall the practice is rated as outstanding.

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 and near misses. Information about safety was reviewed and addressed; although it was not always accurately recorded.
• Risks to patients were assessed and mostly well managed, with significant improvements made to areas such as infection control.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 that they meet people’s needs.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the design and implementation of care pathways specific to long term conditions prevalent within the community.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and the Patient Participation Group (PPG).
• The PPG was proactive in arranging and coordinating health promotion and screening events to promote better health for patients, as well as local support groups for people with long term conditions and carers.
• 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 and this was monitored and reviewed.

We saw several areas of outstanding practice including:

• There was a strong focus on continuous learning and improvement at all levels within the practice. The practice team was forward thinking and took part in local pilot schemes to improve outcomes for patients in the area. For example, the partners had taken a lead role in the design of care pathways for a range of long term conditions and the development of the local GP provider company (primary integrated community services limited). As result, community services were developed to treat and manage conditions such as respiratory conditions, heart failure and cardiology, pain and non-malignant palliative care. Outcomes achieved for patients included services being delivered closer to home, reduction in secondary care referrals and hospital admissions.
• The patient participation group (PPG) had strong links with the local community through facilitating health promotion events and local support groups for lung related health needs and carers. Additionally, the PPG worked in collaboration with two other PPGs to ensure the wider community benefited from the activities they held. Patient feedback showed patients had enjoyed the informative events and received useful information on healthy lifestyle advice.

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

Importantly, the provider should:

• Improve the availability of non-urgent appointments with a named GP and waiting times.
• Ensure completed cycles of clinical audits related to minor surgery in line with best practice guidance.
• Strengthen the systems for assessing and monitoring risks and the quality of the service provision. This includes maintaining accurate and detailed records in relation to the management of regulated activities, practice and clinical meeting minutes and infection control practices.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice