Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Jefferies and Partners, Munster Road on 25 August 2016. Overall the practice is rated as good.

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

• Not all staff had received the appropriate supervision to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. However, patients told us that the service was becoming less personal as they saw a number of different clinicians.
• Patients said they found it difficult to make an appointment with a named GP but they said they could make an urgent appoint the same day.
• 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.
• 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 provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Consider improving communication with patients who have a hearing impairment.

• Review systems to identify carers in the practice to ensure they receive appropriate care and support.
• Improve practice uptake of cervical screening programme amongst eligible women to improve patient care.
• Continue to ensure that all clinical staff receive appropriate and ongoing supervision to carry out their role competently and unsupervised.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Jefferies and Partners on 24 January 2019 as part of our inspection programme.

At the last inspection in 25 August 2016 we rated the practice as good overall.

At this inspection we have rated this practice as good overall and good for all population groups

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 found that:

• 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.
• Staff dealt with patients with kindness and respect. Feedback from patients we spoke with and CQC comment cards stated staff involved and treated patients with compassion, kindness, dignity and respect. Although, results from the national GP patient survey showed some patients reported low satisfaction with consultations. The practice had reviewed this feedback and acted on it.
• Complaints were listened and responded to and used to improve the quality of care.
• The practice organised and delivered services to meet patients’ needs. Although, results from the national GP patient survey showed some patients reported low satisfaction with appointments. The practice had reviewed this feedback and acted on it.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

• Develop a proactive approach to monitoring and reviewing vulnerable patients to protect them from harm.
• Strengthen links with health visitors and other agencies to ensure vulnerable adults and children are helped, supported and protected.
• Review the availability of anaphylaxis kits in all doctors’ home visiting bags.
• Consider ways to reduce Quality and Outcomes Framework (QOF) exception reporting particularly for people with a long-term condition and people experiencing poor mental health.
• Continue to improve cervical screening and childhood immunisation uptake to bring in line with recognised targets.
• Develop quality improvement activity to drive improvement in the quality of care patients receive.
• Maintain the system for identifying and supporting patients who are carers.
• Continue to improve patient satisfaction with consultations and appointments.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice