We carried out an announced comprehensive inspection at Garswood Surgery on the 3rd November 2015. Overall the practice is rated as good.

Our key findings were as follows:

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding. Staff understood and fulfilled their responsibilities to raise concerns and report incidents.

• The practice was clean and tidy. The practice had good facilities in a large purpose built building with disabled access and a lift to the first floor.

• The clinical staff proactively sought to educate patients to improve their lifestyles by regularly inviting patients for health assessments.

• There was a robust system in place to undertake audits at the practice and improve patient care.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met people’s needs.

• Patients spoke highly about the practice and the whole staff team. They said they were treated with dignity and respect and they were involved in their care and decisions about their treatment. Feedback from patients about their care was consistent and strongly positive.

• The practice sought patient views about improvements that could be made to the service, including having a Patient Participation Group (PPG).
• Information about services and how to complain was available and easy to understand. The practice proactively sought feedback from staff and patients, which it acted upon.

• There was a clear leadership structure with delegated duties distributed amongst the team and staff felt supported by management. The staff worked well together as a team.

• Quality and performance were monitored.

We saw areas of outstanding practice including:

• The practice staff organised a number of community initiatives. Previously they had held a fundraising day for MacMillan cancer research and invited their patients and staff to help with the fundraiser. They had organised a coffee day in December 2015 for their patients and invited various groups to come and meet their patients during the event. Organisations such as the falls risk team and the memory clinic staff were due to attend to help raise awareness amongst their patients and the community in regard to the support and services they could offer.

• One GP had collected data over the last 20 years and carried out a yearly audit on patient deaths. They encouraged the practice to reflect each year on all deaths to look at any factors that could be preventable or reflect on the care given. Whilst no areas of concern were identified within the audits the staff had put a lot of work into reflecting and mitigating any risks. The data collated looked at any preventable factors for their death e.g. smoking, alcohol and helped increase awareness amongst GPs with health promotion and looking into the background of patients problems. The GP was due to present the data and research for publication this year.

• In 2014-2015 the practice won an award called a ‘GOLD Quality Placement Award.’ This was for mentoring and teaching undergraduate medical students from a local university and was based on undergraduate feedback regarding the quality of their placement and teaching.

• The practice introduced a tailor made recall system in 2007 which won an award in 2011 for its innovation. It offered a high quality system offering more checks than usual recall systems which ensured the clinical management of patients to be safe and robust. Almost every aspect of patient management with the exception of medication reviews was dealt with using the clinical systems diary facility. Patients were pro-actively managed to avoid deterioration in their health outcomes, for example: cholesterol, weight management and asthma management. Patients were seen holistically for their co morbidities in one appointment and birthday reviews offered a ‘One stop shop’ approach optimising appointments. The system helped the practices management of avoiding unplanned admissions and the proactive case management of vulnerable patients. The system facilitates the identification of patients who found it difficult to attend reviews and smear tests and as a result the practice had put in strategies to accommodate the needs of these patents with late and early morning appointments and home visits.

However there were areas of practice where the provider should make improvements:

• Ensure all staff files evidence the necessary checks such as references to show safe recruitment of staff.

Letter from the Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice