Letter from the Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The practice also has a branch surgery in Little Eversden, Cambridgeshire, but we did not visit this as part of our inspection.

We spoke with several people who attended the surgery in Comberton during the course of this inspection. All of the people we spoke with made positive comments about the kindliness and friendliness of the doctors and nurses and the reception staff. We observed that people were greeted and met by doctors and nurses who escorted them from the waiting room to the various treatment rooms. One person said, “I think it is very good sign and it re-assures me that the doctors show this personal touch. I do appreciate it". Another person said, "I am totally satisfied with the attention and the treatment I have had from the doctors. The doctor I usually see is very kind and listens to me and gives me plenty of time to talk”.

Every person we spoke with told us they could arrange an appointment for the same day, if it were necessary.

Medicines and prescriptions had been safely managed by suitably trained staff.

The practice's safeguarding arrangements to protect children and vulnerable adults from abuse were not robust enough to ensure that the practice would be able to respond to abuse appropriately.

The premises appeared to be clean and well maintained, although fire precautions could be improved.

Staff had not been provided with suitable supervision and there was no record of the training that staff had received.

This practice is rated as Good overall. At the previous inspection in December 2015 the practice were rated as good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Comberton Surgery on 16 April 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.
• The practice’s performance in relation to the Quality Outcome Framework (QOF) results were 99%. This was above Clinical Commissioning Group (CCG) and national averages.
• The practice offered health checks for patients aged over 75 and patients with a learning disability, the practice acknowledged the uptake of these health checks could be improved.
• We saw evidence that learning points were discussed in management meetings and staff we spoke to were aware of these.
• There were comprehensive risk assessments in relation to building safety issues such as fire safety and health and safety.
• Cleaning staff had access to the dispensary out of hours when there were no dispensary staff present. The practice demonstrated the safety measures they had in place to mitigate any risks but had not undertaken a formal risk assessment.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff told us that they were happy to work at the practice and felt supported by the management team. Staff told us they were encouraged to raise concerns and share their views.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Results from the July 2017 national GP patient survey were in line with and above local and national averages. Feedback from patients we spoke with and received comments from supported these findings. The practice had a patient participation group, however at the time of our inspection this group was not active.
• We saw evidence that written complaints were handled effectively, although verbal complaints were not always recorded and the opportunity to analyse trends was missed.
• There was a focus on continuous learning and improvement at all levels of the organisation. The practice was a training practice for GP trainees and for medical and nursing students.

The areas where the provider should make improvements are:

• Review and improve the uptake of health checks including those for patients with a learning disability and those patients aged over 75.
• Review and improve the engagement of staff with the patient participation group.
• Review and improve the documentation of verbal complaints.
• Formalise the risk assessment for external staff accessing the dispensary out of hours.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice