Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sprake & Partners on 13 September 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Nationally reported data showed that outcomes for patients with long-term conditions were consistently better than national averages. The practice had achieved at least 99% of the total points available in all but one of the 19 quality and outcomes framework (QOF) clinical indicators:
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• 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 were able to get an appointment with a GP when they needed one, with urgent appointments available 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 in place and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.
• Managers promoted a culture of continuous reflection and learning. Clinical education meetings were held twice weekly. One of the GP partners and the practice manager had completed a strategic leadership skills course.
• There were very high levels of staff satisfaction. There was a stable team; the majority of staff had worked at the practice for many years. Staff told us they were proud to work at the practice and many referred to the practice as a fantastic place to work.

We saw several areas of outstanding practice including:

• Innovative training processes were in place, this included members of the practice’s patient participation group (PPG) carrying out ‘simulated surgeries’ with the trainee GPs. There were comprehensive debriefs following the surgeries with the PPG patients, trainee GPs and their trainers to ensure all learning was captured. The practice was keen to promote general practice as a career choice and as such, had invited a number of sixth form students to work in the practice on a two day placement.
• Clinicians worked closely with patients and their families to prepare care plans and help prevent unnecessary admissions to hospital. In the previous year, the practice had the lowest non-elective (emergency) admission rate across the clinical commissioning group (CCG), 293 per 1,000 population, compared to the average of 413.
• One of the doctors was a GP with a special interest (GPwSI) in musculo-skeletal services. As a result, the practice was able to reduce referrals to secondary care by treating patients within the practice. The practice’s referral rate to orthopaedics outpatient services was the lowest across the CCG (31.5 per 1,000 population, compared to the average of 47.7). Other neighbouring practices also used the service provided by the GP and their referral rates were also well below average (37.4 and 35.5 per 1,000 population).

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice