Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr J Sullivan & Partners, known as Moorside Surgery, on 3 November 2016. Overall the practice is rated as good, with the provision of effective services being rated as outstanding.

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

• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients’ needs were assessed and care was planned and delivered following local and national care pathways and National Institute for Health and Care Excellence (NICE) guidance.
• Patient comments we received were overwhelmingly positive about the practice. The national patient survey had shown that patient scores for positive experiences were consistently higher than local and national averages. For example, 90% said they could easily get through to the practice by telephone (local 61%, national 73%) and 100% said they had confidence and trust in the last GP they saw or spoke to (local and national 95%).
• The practice staff had a good understanding of the needs of their practice population and were flexible in their service delivery to meet patient demands.
• The practice provided intensive support and interventions for those patients who had learning disabilities, complex mental health problems or were high users of NHS services. For example, some patients were given regular two weekly appointments to help maintain a stable lifestyle. Patients had direct access to regular support from a psychologist, psychiatrist or physiotherapist as needed, to prevent an inappropriate hospital admission.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice sought views on how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and engagement with patients and their local community. For example, a children’s play area had been developed in conjunction with the patient participation group
• Risks to patients were assessed and well managed and there were effective safeguarding systems in place to protect patients and staff from abuse.
• The practice promoted a culture of openness and honesty. All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
• There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive.
• The practice complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment.)

We saw several areas of outstanding practice:

• The practice participated in the Bradford Health Hearts programme and could evidence that 100% of patients who had atrial fibrillation were being monitored for their anticoagulation (blood clotting) rates. This is essential for the safe management of this disease and the prevention of strokes. We saw evidence that the practice was the highest achieving in this area across Bradford and had received an award from the Clinical Commissioning Group (CCG) in recognition of their work.
• The practice facilitated many services to effectively manage and improve outcomes for patients. For example, newly diagnosed diabetic patients had access to the unique practice developed ‘getting started’ programme. Sessions were run with the practice nurse and a dietician to educate patients regarding dietary and lifetstyle choices to support positive self-management of their care. The practice had also participated in the Early Arthritis research project and they were one of three pilot sites in the CCG for Physio First (a self-referral direct access service to physiotherapy interventions). One of the GPs (who was on the advisory group for the National Institute for Health and Care Excellence) led a specialist headache management clinic which patients from other areas could also access.
• The practice worked within the local community and had facilitated a young people’s ‘eating for exams’ workshop and had also funded a drama group to work in the local secondary school focusing on healthy lifestyle awareness, such as bullying, sexual health, drug use and mental health. We saw evidence of very positive feedback received from participants with regard to these interventions.

However, there was an area of practice where the provider should make improvements:

• The practice should reassure themselves that all vaccines are transported to patients’ homes in accordance with the most recent public health guidelines.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice