This practice is rated as Good overall.

(Egton Surgery is a new registered single handed practice and this is the first inspection of this service under this provider.)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Outstanding

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Egton Surgery on 25 April 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. 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 care and treatment was delivered according to evidence- based guidelines.

• Clinicians had access to appropriate information to deliver safe 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 was provided to help patients to understand the care available to them.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported they were able to access care when they needed it. Patient feedback on the care and treatment delivered by all staff was overwhelmingly positive.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw areas of outstanding practice:

• We were provided with many examples of feedback from patients to say how they valued the care delivered by all members of staff and the support they provided. The staff provided lifts to take patients to appointments and the nurse worked during her lunch time to accommodate patients struggling with transport issues.

• The practice, in collaboration with a neighbouring practice developed processes to share some management responsibilities, improve learning and share best practice. These arrangements included the development of a practice nursing team with specific skills that can be used across the practices.

• Patients and their families at the end of life were given the GPs personal mobile phone to contact 24hours seven days of week to contact them if they were needed.

• Patients were also able to access the skills of GPs with specialist skills at this practice or one of the nearby practices There is formal agreement with the neighbouring practices to access these skills. This reduced the need to refer patients to secondary care which means a considerable journey for some patients.

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