Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Farnham Road Surgery on 5 January 2017. Overall the practice is rated as good. Specifically it is rated good for the provision of safe, effective, caring and well led services and outstanding for delivery of responsive services.

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

• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns. Learning and trends from complaints were shared with stakeholders. For example, with the patient participation group (PPG).
• Patients said they found it easy to make an appointment, there was continuity of care. Urgent appointments were available the same day and appointments were offered on both Saturday and Sunday mornings.
• 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.
• A wide range of services were provided at the practice to facilitate easier access for patients and reduce time consuming and costly trips to hospitals and other clinics.

We saw areas of outstanding practice including:

• Learning from significant events was central to improvement in practice performance. Detailed presentations of significant events were given to staff at team meetings to ensure consistent learning. Significant events were shared with the patient participation group and other external stakeholders to facilitate wider learning and improvement.

• Patients individual needs and preferences were central to planning of services. The practice provided specialist clinics, led by the GPs, to increase attendance and reduce referrals. These included: dermatology and orthopaedics. Data showed this increased attendance and reduced referrals to hospitals and other clinics.

• The practice took an active role in provision of services to the wider community and those in vulnerable circumstances. They provided a specialist drug and alcohol prescribing service to both registered patients and those from other practices in the area. This recognised that this group of patients frequently found contact with new services difficult.

The areas where the provider should make improvement are:

• Ensure exception reporting for patients diagnosed with diabetes is reviewed.
• Ensure a system is put in place to provide patients diagnosed with a learning disability to access annual health reviews.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our visit we spoke with ten patients. Patients told us they were involved in their care and treatment and were provided with treatment options and choices when necessary. One patient told us “I am given choices” and another patient told us “I am involved in my own treatment.” A third patient told us “I am definitely involved in the decisions.” This showed patients were involved in decisions about their treatment.

Patients we spoke with told us they felt confident with care and support provided by the GPs and clinical staff. Generally feedback was positive about the service and the approach of the GPs and staff in the surgery. Comments included “Excellent; never had a problem”, “In general very happy” and “Very happy.” Two patients told us they didn’t “feel rushed” during appointments.

We found patients who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. There were suitable arrangements in place for all staff to be able to recognise and report safeguarding concerns to the relevant authority.

We found patients were cared for, or supported by, suitably qualified, skilled and experienced staff and patients were made aware of the complaints system. Patients we spoke with did not express any concern about the care and treatment they had received. One patient told us they had made a complaint on behalf of her mother and told us that it was “dealt with amicably.”