We carried out an announced comprehensive inspection at Dr Bell and Partners (also known as Practice 3) on 20 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centred care.

Whilst we found no breaches of regulations, the provider should:

• Review and improve the analysis of incidents and sharing of lessons with all staff in the practice.
• Review and improve the monitoring of exception reporting for Quality and Outcome Framework indicators.
• Review and improve the system for monitoring mandatory training and maintaining records of training.
• Review and improve the system for identification of carers.
• Review and improve complaints responses.

We saw an area of outstanding practice:

The practice had introduced the ‘care navigation’ signposting system giving patients convenient access to the most appropriate health care professional. All patients were offered a same day appointment or were given telephone appointments if appropriate, which had freed up more same day appointments for the patients that needed to be seen face-to-face. When the patient arrived at the surgery, they would be seen by a health care assistant who would check their observations, i.e blood pressure and temperature and do any blood tests that had been requested by the GP. The GP would then see the patient and request any further investigation such as X-ray which were done at the local hospital. We saw two patients had been given same day appointments and then after being seen and having further investigations were referred to hospital where confirmed cancer diagnoses were made'.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Harris & Partners on 15 December 2015. 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.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had 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.
• 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.
• 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.

We saw an area of outstanding practice including:

• A Photo Dermatology service was available at the practice. The GP took a photograph of skin conditions and sent them to the Dermatologist at the hospital for review who would make a decision about what care was required. This reduced the number of referrals made and the need for patients to travel to Hull for an appointment.

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

Importantly the provider should:

Ensure there is an audit trail of blank prescriptions forms.

Ensure all staff are up to date with mandatory training.

Ensure the practice’s vision is documented in a written strategy and outlines their plans for the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice