Letter from the Chief Inspector of General Practice

We carried out our inspection on 25th November 2014. We inspected College Way Surgery as part of our new comprehensive inspection programme.

Overall we found the practice is rated as good with some aspects of their practice being outstanding. We saw many examples of a safe, effective, caring, responsive and well led practice. Patients reported high levels of satisfaction with the practice during our inspection and this was reflected in the comment cards we also received.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Lessons were learned and communicated widely to support improvement. Information about safety was recorded, monitored, appropriately reviewed and addressed. Risks to patients were assessed and well managed. There were enough staff to keep people safe.
• Our findings at inspection showed systems were in place to ensure all clinicians were up to date with both NICE guidelines and other locally agreed guidelines. We saw evidence to confirm these guidelines were positively influencing and improving practice and outcomes for patients. Data showed that the practice was performing highly when compared to neighbouring practices in the Somerset Clinical Commissioning Group (CCG) and nationally. The practice was using innovative and proactive methods to improve patient outcomes and it linked with other local providers to share best practice.
• Data showed patients rated the practice higher than others for several aspects of care. Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Information to help patients understand the services available was easy to understand. We also saw staff treated patients with kindness and respect and maintained confidentiality.
• The practice reviewed the needs of its local population and engaged with the NHS area team and CCG to secure improvements to services where these were identified. Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. 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 and evidence showed that the practice responded quickly to issues raised. Learning from complaints with staff and other stakeholders.
• The practice had a clear vision with quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff. High standards were promoted and owned by all practice staff and teams worked together across all roles. Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice. There was a high level of constructive engagement with staff and a high level of staff satisfaction. The practice gathered feedback from patients using available technology, and it had a very active patient participation group (PPG).

We saw several areas of outstanding practice including:

• Following patient feedback from the last patient participation group survey the practice had commenced a series of educational events for patients, most recently about diabetes.
• The practice had adopted a call centre approach to their telephone booking system with up to 12 lines being available for incoming and outgoing calls.
• Constant monitoring of the appointment system provided additional appointments if needed and in-house locums were booked where demand exceeded planned appointments.
• The practice had worked towards being a dementia friendly practice. The entire practice staff team had received training from the attached pharmacist who is a Dementia Champion.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection November 2014 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Good

We carried out an announced inspection at College Way Surgery on 3 May 2018 as part of our inspection programme.

At this inspection we found:

• 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.
• The practice undertook additional patient surveys for individual GPs and additional clinics. The survey outcomes reflected the national GP patient survey results showing significantly above average scoring.

We saw areas of outstanding practice:

The practice prioritised and worked proactively in ensuring services were delivered in ways that would improve patient outcomes. Services were proactively planned to meet a diverse range of patient need. We saw improvements in care for patients as a result of ongoing monitoring, clinical audit and quality improvement work, provision of additional services such as a dermatology clinic when the local service closed, engagement with community projects and local pilot schemes.

There was a strong focus on creating a culture of education, continuous learning and improvement at all levels within the practice. For example, all GPs acted as trainers and had received an excellence rating from the local deanery.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice