Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Watson & Partners on 24 September 2015. Overall the practice is rated as outstanding.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• There were systems in place to reduce risks to patient safety, for example infection prevention and control procedures and health and safety assessments.
• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents, near misses and any identified safeguarding issues.
• Information about services and how to complain was available and easy to understand.
• The practice sought patient views on how improvements could be made to the service, through the use of patient surveys family and friends test and via the practice’s patient participation group (PPG).
• Urgent appointments were available for patients the same day.
• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as priority. A business plan was in place and was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• We saw that the practice was responsive to the needs of the local population. For example, the practice had increased the flexibility of access to appointments and could demonstrate the impact of this by reduced use of the out of hours and secondary acute service and very positive patient survey results. We saw that in response to patients’ feedback they had looked at innovative ways to improve access with a ‘24 hour interactive telephone system’ where patients could book an appointment with their chosen GPs (for appointments within surgery hours) at any time over a twenty four hour period seven days a week. Fifty percent of the available appointments for the practice were available in this way.
• The practice had a very good skill mix which included advanced nurse practioners (ANP) who provided daily visits and support to a local nursing care home for those with a high need for medical care. The impact was to reduce unplanned hospital admissions and allowed for more effective use of GP hours.

• The practice provided comprehensive screening and regular reviews for patients at risk of developing long term conditions. The practice supported individuals with a named nurse and regular telephone consultancy to aid self-management of their condition. Long term conditions were regularly monitored and recalls made. Patients with diabetes had access to a consultant diabetologist at the practice.
• The practice has been innovative in its efforts to meet the needs of more patients. It employs ANPs and Physician Assistants and this enables the practice to offer an appointment system that is flexible to the health needs of patients. There is also an effective mentorship programme that supports these additional roles within the practice.
• The practice provided a weekly link for patients with mental health needs to access ‘Right Steps’ support sessions. This is part of improving access to psychological therapies (IAPT) scheme. Patients can self-refer into the service in order to receive support promptly.
• The practice monitored accident and emergency (A&E) attendance daily and directly contacted patients who had attended A&E to review where access to their service could improve.
• The practice contacted ‘carers’ to offer individual support and direct them to additional services.
• The practice held a weekly dedicated Dementia ‘memory’ clinic. All staff and the PPG had received dementia training.
• The practice had a health trainer to support weight management, alcohol reduction and smoking cessation and could demonstrate this had a positive impact for patients using this service.
• The practice offered enhanced services including a prostate clinic and bladder scanning service, joint service and in-house physiotherapy, audiology and ultrasound services.
• The practice looked at organisational values and future visions in monthly staff meetings and organised team ‘away days’ to promote ideas and team development.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Dr Watson & Partners on 10 April 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.