Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection July 2015 – Good)

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

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive follow-up inspection at Marfleet Group Practice on 13 December 2017 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.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• The practice implemented service developments using input from clinicians to understand their impact on the quality of care.

• The practice had implemented a new telephone system for patients to allow them to efficiently select the service they need.

The areas where the provider should make improvements are:

• Clinical audits should include a full cycle of events to ensure patient outcomes are improved and reflection and learning is recorded with action points identified.

• Consider Mental Capacity Act training for all staff.

• Consider implementing further systems to ensure patient access to appointments is improved.

• Although team meetings take place on an ad-hoc basis the practice should develop more formal regular reviews for staff to have

• The overall Quality Outcome Framework (QOF) exception reporting rate was 17% compared with a national average of 10%. (QOF is a system intended to improve the quality of general practice and reward good practice. Exception reporting is the removal of patients from QOF calculations where, for example, the patients decline or do not respond to invitations to attend a review of their condition or when a medicine is not appropriate.)  The practice should consider further systems to ensure the exception rate figure is improved.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marfleet Group Practice on 7 July 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and for being well led. It was also good for providing services for older people and people with long term conditions.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• The practice safely and effectively provided services for all patient groups. The staff were caring and ensured all treatments being provided followed best practice guidance.

• The practice had systems and processes in place to ensure they provided a safe service.

• The practice had an effective governance system in place, was well organised and actively sought to learn from performance data, complaints, incidents and feedback.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

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

Action the provider SHOULD take to improve

• Ensure a risk assessment is completed where the practice has elected not to carry emergency drugs on home visits.
• Ensure patient appointments and waiting times are effectively monitored and managed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our announced inspection we spoke with eight patients, two members of the patient participation group, the registered provider (Dr Weir), one GP, the practice manager, two practice nurses, and two reception members of staff.

Patients told us they felt their privacy and dignity was protected when they visited the practice. Comments included; “I always feel safe in the surgery and the doctor always treats me with respect" and “The doctor always listens to me and they take the time they need with my appointment”. One person told us that they weren't always happy with the service but they would complain if they needed to.

Patients expressed their views and were involved in making decisions about their care and treatment. We saw that patients were given information and support with regards to treatment options and that staff maintained patient’s privacy and confidentiality.

Staff had received appropriate professional development and training to ensure they could meet the needs of the people who used the service. Staff could tell us who they would contact if they had any concerns about child protection issues or abuse of patients. The practice had systems in place to assess and monitor the quality of the service that people received.

There was a complaints system in place and this was available to all the patients. We spoke with one person who had complained and they told us their complaint had been dealt with appropriately.

We saw that records were up to date accurate and stored securely.