Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Langton & Partners on 4 August 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well led, effective, caring and responsive services. It was also rated as good for providing services for all of the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 there was continuity of care, with urgent appointments available the same day.
• 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 practice facilities were designed and equipped to meet patients’ treatment needs.
• Information about how to complain was available and easy to understand.

We saw areas of outstanding practice including:

• The practice funded a care coordinator who contacted all patients after they had been discharged from hospital to make sure they had adequate support and to provide information for services.
• As part of their service development for older people the practice had allocated time for a member of staff to act as a community resource lead and actively contact older patients and signpost them to community support services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating August 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Monks Parks Surgery on 16 August 2018 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.
• 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 positive patient feedback with families remaining patients at the practice for several generations.
• There was a focus on continuous learning and improvement at all levels of the organisation.
• The practice manager had initiated an internet based ‘Nurse Base Camp’ which provided a resource base, support and communication network for all nurses within the practice cluster (a Cluster is a group of GPs working with other health and care professionals to plan and provide services locally).
• The practice had systems and processes in place to review the practice performance. However, there was no formalised clinical oversight for the effectiveness of the care provided.
• There was clinical supervision available for the GPs however the nurses were not included. There was no clinical lead for the nurses.

The areas where the provider should make improvements are:

• Risk assess the emergency medicines which were not held by the practice.
• Retain evidence of documentation reviewed as part of the recruitment process such as qualifications.
• Establish effective systems and processes to ensure clinical oversight supports the effective delivery of treatment including treatments provided by the nurse team such as cervical screening.
• Review the practice treatment protocols so that there is a continuity of care for patients.
• Review the protocol for exception reporting so that the decision making process is clear.
• Review the process for responding to medicine safety alerts so that the practice document actions taken to rectify concerns.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.