Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dolphins Practice on 10 August 2016. 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 an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and well managed. However, the use of blank computer prescription paper for use in printers was not tracked.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients said there was continuity of care, with urgent appointments available the same day. However, results from the national GP patient survey showed that patients’ satisfaction with how they could access care and treatment was lower than local and national average.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Track and record the use of blank computer prescriptions.

• Look at ways of to improve patients’ satisfaction with access to care and treatment to include phone access and opening hours.

• Keep exception reporting rates under review in areas where they are higher than the local and national average. (Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with seven patients, three of whom were members of the practice's Patient Participation Group (PPG). Most of the patients were happy with the care and treatment they had received. One said, "The doctor I have is wonderful." Another said, "The doctors are brilliant. The nurses are brilliant." However, some patients said they found the appointment system difficult and couldn't always get to see the GP of their choice.

We spoke with two GPs, one practice nurse and three administrative staff. They all said they were provided with sufficient training opportunities and felt well supported in their roles. One said, "We get good training."

We found that the practice had policies and procedures in place to safeguard children and vulnerable adults. We saw that training was provided to ensure that all staff were aware of their roles and responsibilities in relation to this. This meant that patients who used the service were protected from the risk of abuse.

The practice had a system in place to monitor the quality of service that patients received. The practice regularly sought the views of patients through surveys and the PPG. There was evidence that these were acted on to improve the service. We saw that learning took place from significant events and that the practice shared and implemented the findings of clinical audits.