Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mark Deverell (The Old Dispensary) on 17 August 2016. Overall the practice is rated as Outstanding

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

• 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. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• The practice employed a healthcare assistant to specifically look after patients aged over 75 years where they had been discharged from hospital, attended the local accident and emergency department or had frequent contact with the practice. This was to facilitate any changes with their medicines, address their concerns and/or improve their situation to avoid further crises.

• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs. The practice was clean, tidy and hygienic. We found that arrangements were in place that ensured the cleanliness of the practice was maintained to a high standard.
• 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 provider was aware of and complied with the requirements of the duty of candour.
• The practice had focussed on patient education and empowerment for more than fifteen years as a way of promoting active citizenship. This had led to a sustained improvement in the health of the population and a reduction in resource utilisation. Through active commissioning through the practices PMS contract this had led to increased investment in the practices facilities.

We saw areas of outstanding practice:

There were comprehensive systems in place to keep people safe, which took into account the current best practice. The whole team was engaged in reviewing and improving safety and safeguarding systems. Innovation was encouraged to achieve sustained improvements in safety and continual reductions in harm. Examples being, all clinical staff were trained to level three in safe guarding children and all surfaces for example, walls, flooring, blinds and seating had contained or been treated with an antibacterial substance for hygienic cleaning.

Staff were consistent in supporting people to live healthier lives through a targeted and proactive approach to health promotion and prevention of ill health, and every contact with patients has been used for many years to do so. For example, this had resulted in lower patient numbers with chronic diseases and a low smoking prevalence of 9% of their patient population.

People who used the services were active partners in their care and patient feedback was continually positive about the way staff treat them, for example nationally reported data was consistently higher than national average. For example, 92% of patients said the last GP they saw was good at involving them in decisions about their care compared to the national average of 82%.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice