Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Irlam and Partners on 13 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice ensured that when things went wrong that these were investigated and learning was shared with staff. Risks to patients and staff were assessed and well managed. There were systems for assessing risks including those associated with medicines, premises, equipment and infection control.
• There was a detailed business continuity plan to deal with untoward incidents that may affect the day to day running of the practice.
• Staff were recruited robustly with all of the appropriate checks carried out to determine each person’s suitability and fitness to work at the practice. This included locum nurses and GPs.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Clinical audits and reviews were carried out to make improvements to patient care and treatment.

• Staff were supported and received role specific training to meet the needs of patients and there was a system for staff appraisal.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients who required extra support and those who were carers were identified and monitored.
• Information about services and how to complain was available and easy to understand. Complaints were investigated and responded to appropriately and apologies given to patients when things went wrong or they experienced poor care or services.
• The majority of patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent and same appointments available. Late evening appointments, home visits and telephone consultations were available.
• 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 to make improvements to the services provided.

However there one area of practice where the provider should consider making improvements.

Importantly the provider should:

• Consider providing an automated external defibrillator as part of its emergency equipment in line with best practice guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with four people who were using the service at the time of our inspection. They had all been registered with the practice for a number of years. They were generally pleased with the practice and staff, whom they said were very helpful. Two people said that, at times, they found it difficult to get a routine appointment within two weeks. Two people told us that although one doctor was very knowledgeable and competent, they did not have a very nice ‘bed-side manner’ and that this had been raised with the practice manager. They said that they chose not to see this doctor any more.

We also spoke with three members of the practice’s patient participation group (PPG). They felt that the practice was proactive in sharing information with the group and that they were keen to get their views. The PPG had been involved in carrying out patient surveys at the practice and assisted in devising the questionnaire. One of the members we spoke with was also a member of the local Healthwatch, the national consumer champion in health and care, and was, therefore, in a good position to share and discuss issues affecting people in primary care from a national and local level.

We found that people were generally respected and well cared for by staff. We found that staff were supported to carry out their work and that the quality of the service was assessed and monitored. However, infection control practices were not meeting the required standard.