This practice is rated as requires improvement overall. (Previous inspection 02/2016 – Rating Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Outstanding

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced inspection at The Witley and Milford Medical Partnership on 24 May 2018. The inspection was part of our planned inspection programme.

At this inspection we found:

• The practice had systems to manage risk so that safety incidents were less likely to happen. However, when incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was an active patient participation group in place who told us that they had seen improvements within the practice.
• Patient survey results were extremely positive and higher than the clinical commissioning group (CCG) average in all questions.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• However :-
• Risks to patients were not always assessed and well managed. For example in relation to health and safety, Legionella and medicines management.
• The practice was unable to demonstrate that staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. For example, information supplied by the practice detailed not all staff had received training areas such as mental capacity training or the principles of health and safety.

We saw one area of outstanding practice:

• The practice ran a charity that provided funding to supply a night sitting service for palliative care patients in the area of Waverley. This enabled carers to get rest and provided comfort for the patients.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients. In particular risk assessments and action plans in relation to Legionella, fire and health and safety.
• Ensure the management of medicines keeps patients safe. In particular, in relation to the security of blank prescription stationery for use in computers, controlled drugs and emergency medicines.
• Ensure staff employed in the provision of regulated activities receive the appropriate training and professional development necessary to enable them to carry out their duties.

The area where the provider should make improvements:

• Take action to review their complaints procedure so that the information within this complies with the NHS complaints procedure.

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 Witley Surgery on 17 February 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.
• Feedback from patients was consistently and strongly positive and patients said how caring the practice was.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. Results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was better than local and national averages.
• 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 two areas of outstanding practice:

• The practice had recognised a problem with the services for night sitting for palliative care patients and had set up a charity which raised funds to provide night sitting services. This made a significant difference to palliative care patients.

• The practice had a dedicated GP focussing on frail patients and avoiding hospital admission.

The areas where the provider should make improvement are:

• Improve accessibility of the patient toilet by fitting a support rail and emergency pull cord.

• Review the practice training policy and ensure there is a means for staff to keep up to date with training if they are unable to attend an in house training session

• Consider arranging for an external audit of controlled drugs in the dispensary to provide reassurance of the control required for storage of these medicines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice