Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Seabrook and Partners on 19 January 2017. Overall the practice is rated as Good.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• Feedback from patients about their care was consistently and strongly positive. Patients were extremely positive about the practice’s named and usual GP systems.

• 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 worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example the practice was working across the locality and with neighbourhood practices to input into future changes in local NHS service delivery.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient reference group (PRG). For example a new telephone system was implemented after patient and Patient Reference Group (PRG) feedback
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw three areas of outstanding practice:

• The practice employed a Proactive Care Nurse. This role was solely to maintain current care plans for all registered patients with complex multiple conditions and those in care and nursing homes. Weekly visits were undertaken to the homes and admissions to hospital had reduced as a result. Staff were also assisted in the homes via training and support sessions on various conditions and their treatments.

• The practice had implemented a primary care specialist diabetes service which gave intense patient centred care for those patients with regular uncontrolled diabetes, multiple clinical risk factors and who were historically hard to engage with conventional treatments in the hospital settings. Audits undertaken had seen a marked reduction in multiple risk factors, such as cholesterol, blood pressure levels and Body Mass Index (BMI) and high patient compliance and satisfaction.

• The practice provided a 24hr BP monitoring service to its own patients and those in locality practices. The service provided 15 appointments per week and had been used by over 1,100 patients, 70% of which were from other practices.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection of Dr Seabrook and partners we spoke with six patients. We met four of the general practitioners and spoke with the doctor who takes the lead for safeguarding. We spoke with four other clinical and administrative staff.

Patients spoke highly of the service provided by the practice. They said “They treat you properly” and “You feel welcome when you come to reception or you ring them up”. One patient told us that they thought that the doctors “keep an eye on you, they take an interest and monitor you if they think you’re vulnerable” and that “The doctor took an interest in me when I thought they might be too busy. They have kept in touch with me”. Another patient said that “They keep in touch. They ring up when they need to”. Other comments made by patients included “They followed-up – even when there was no need”, “It’s two way – it’s important to have a relationship – they offer this to you”, and “They’re not just doing it to you”.

Patients said that it was sometimes difficult to get an appointment with a chosen doctor. They said “It is very good but it is very hard to get an appointment (to see your own doctor)”. This patient confirmed that they had been able to make an emergency appointment with another doctor at the practice. Another patient said “It takes you a long time to get the doctor you want to see. I imagine it is the numbers (of patients) and you can’t do anything about that”. A third patient said “If you’ve got something you’re worried about you can see any doctor”.

We looked at both of the sites from which Dr Seabrook and partners provide the service and also reviewed records.