We carried out an announced comprehensive inspection at Dr Thorniley-Walker and Partners on 12 December 2018 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups. (Previous rating June 2015- Good)

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way. GP patient survey results were all above local and national averages for how easy patients found it to access appointments.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Continue to develop a systematic practice wide approach to clinical audit, to clearly demonstrate improvement in patient outcomes.
• Carry out a formal risk assessment of identified hazards, such as the stone statue in a patient accessible area.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Thorniley-Walker and Partners on 16 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for the following population groups: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); People whose circumstances may make them vulnerable; People experiencing poor mental health (including people with dementia).

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 majority of 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 offered pre-bookable early evening and early morning appointments two days per week, which improved access for patients who worked full time.
• 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.
• Staff throughout the practice worked well together as a team.

We saw an area of outstanding practice:

• Significant event meetings were held on a quarterly basis; chaired each time by a different GP, to promote transparency and ensure all were involved. Prior to each meeting the chair would review the reported incidents and appoint a score to each one. The score then determined the action to be taken, for example, whether to carry out a full review or share any learning points. In addition to the incidents reported by staff, the practice manager also considered any negative reviews on patient websites to be significant events. The issues were logged and discussed as with any other event.

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

The provider should:

• Maintain clear records on prescription stationery stock, in line with guidance from NHS Protect;
• Carry out a risk assessment to determine which emergency drugs are required by the practice, and document the findings.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice