Letter from the Chief Inspector of General Practice

We inspected this service on 1 October 2014 as part of our new comprehensive inspection programme.

The overall rating for this practice is good. We found the practice to be good in the safe, caring, responsive and well-led domains and outstanding in the effective domain. We found the practice provided good care to older people; people with long term conditions; people in vulnerable circumstances; families, children and young people; working age people and people experiencing poor mental health.

Our key findings were as follows:

• Patients were kept safe because there were arrangements in place for staff to report and learn from key safety risks. The practice had a system in place for reporting, recording and monitoring significant events over time.
• The practice recognised that patient satisfaction with access to appointments had fallen over the past year. There was evidence that the practice had made changes to respond to this and on-going monitoring demonstrated that changes still needed to be considered. The practice had been working with the Local Area Team, Clinical Commissioning Group and Patient Participation Group (PPG) to address this issue. PPGs are an effective way for patients and GP practices to work together to improve the service and to promote and improve the quality of care patients receive.
• There were systems in place to keep patients safe from the risk and spread of infection. Systems were in place to monitor and make required improvements.
• Evidence we reviewed demonstrated that most patients were satisfied with how they were treated and that this was with compassion, dignity and respect. It also demonstrated that the GPs were good at listening to patients and gave them enough time.

We saw several areas of outstanding practice including:

• The provider had developed a referrals feedback slip to gather information from the hospital physiotherapy department to monitor the appropriateness of their patient referrals.
• The lead nurse at the practice was supported by the GP partners within and outside of the service to take on a leadership role. An example of this is where the lead practice nurse led and chaired the local practice nurse forums to promote best practice in the administration of influenza, pneumonia and shingles vaccinations for older people.

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

The provider should:

• Ensure that all electrical equipment at the practice is safety tested.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Th

is practice is rated as Good overall. (Previous rating 2014 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Dr Law & Partners on 31 October 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.
• 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.
• The practice understood the needs of its population and tailored services in response to those needs. There was evidence of a number of projects and services the practice had been involved with to ensure patients’ needs were met.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• The appointment system had changed to a Care Navigation system in which reception staff had been in receipt of appropriate training.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

There were areas of outstanding practice:

• The practice had developed a number of bespoke protocols and ‘intelligent’ templates on the electronic record system which included automated prompt messages for care plans, referral forms and links to information support packs/guidance and local services, so that GPs were able to ensure patients received standardised, up to date and timely care and treatment at the point of need.
• The practice identified the need for additional primary care input into local care homes to improve outcomes for older people with urinary tract infections. As part of this project, the practice provided training to care home managers and staff on their ‘urinary tract infection pathway’ which strengthened systems and ensured older people received effective care and treatment. This was being considered as potentially being rolled out CCG wide.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

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