Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Seyan & Partners on 15 March 2016. Overall the practice is rated as good.

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 the skills, knowledge and experience to deliver effective care and treatment.
• 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.
• The practice engaged with local commissioners and other stakeholders to ensure that services were tailored to meet the needs of the practice’s population groups. For example, a number of services offered by the practice meant that care could be provided closer to home.
• Most patients said they found it easy to make an appointment with a named GP. Patients were able to access urgent appointments on the same day.
• 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 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.

We saw several areas

of outstanding practice:

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. For example, the practice provided an anticoagulation service led by a GP and the practice nurses. Patients from across the Clinical Commissioning Group (CCG) were able to access the ‘anticoagulation hub’ which reduced the need to attend the hospital for monitoring. The practice nurses also provided domiciliary anticoagulation visits to 30 housebound patients who were registered with the practice to provide continuity of care.

• There were innovative approaches to providing care closer to home. For example, the practice provided an in-house gynaecology service utilising a practice GP with a special interest in gynaecology, to reduce the need for patients to be referred to hospital gynaecology services. For 2014/15, the practice had only found it necessary to refer one patient to secondary care for gynaecology, which was the lowest referral rate in the CCG area for this service.

• The practice had also identified that they needed to improve access to psychological therapies for their patients. In addition to referring to local psychological support services the practice had arranged for in-house counselling services approximately three days per week. From January 2015 to December 2015 the in-house counselling team saw 48 patients with a waiting time that varied from two weeks to six weeks. The waiting time for the local psychological support service was three months, demonstrating that patients were able to access mental health support more quickly via the in-house service.

The areas where the provider should

make improvement are:

• Ensure that medicines management procedures include robust monitoring of emergency medicines.

• Ensure that care planning is holistic and patient centred in order to assess and monitor patients’ needs effectively.

• Ensure that the practice has robust systems in place to be able to identify and support all patients acting as carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice