Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Corfe Castle Surgery on 19 July 2017. Overall the practice is rated as good.

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. A failsafe process was in place for monitoring blood tests and medical alerts and for managing reviews and screening.
• Staff were aware of current evidence based guidance and adopted these guidelines within clinical templates. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey were consistently higher than local and national averages and 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.
• Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. Patients particularly appreciated the daily ‘sit and wait’ system.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice identified military veterans in line with the Armed Forces Covenant 2014. This enabled priority access to secondary care to be provided to those patients with conditions arising from their service to their country.

• There was a clear leadership structure and staff felt supported by management. 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 had proactively identified over 4% of the practice population as carers and provided them with the support and guidance needed.
• Staff promoted the friends of Corfe Castle group who provided transport and medicine delivery services to patients in the village.

• The practice worked effectively with members of the community to ensure vulnerable patients were identified and received the care they required. For example, through schools and the local church.

• The GPs worked with staff at the two local community hospitals to access a step down service from secondary care to rehabilitation and for those who need admission to hospital but not necessarily to the district general hospital.

• The practice used an ‘Avoidance of Unplanned Admission’ (AUA) register. Patients on this registered were assessed and discussed monthly at the multi-disciplinary team meeting.

• The practice, in conjunction with the locality, had developed a virtual ward where at risk patients were discussed on a daily basis within the integrated care team.

• Patients with respiratory disease had access to pulmonary rehabilitation groups and were cared for at the practice by a GP with a specialist interest.

• Patients with diabetes and pre diabetes received proactive, innovative and pioneering approaches to diabetic care. For example; structured education sessions and access tomonitoring devices for continuous monitoring of patients’ blood glucose. The practice were beginning to observe patient benefit from this form of monitoring, including reduced blood glucose levels.

We saw one area of outstanding practice:

Patients were truly respected and valued as individuals and are empowered as partners in their care. Feedback from patients, those who are close to them and stakeholders was continually positive about the way staff treat people. Patients said that staff were highly supportive, responsive and go the extra mile and the care they receive exceeds their expectations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice