This practice is rated as Good overall. (Previous rating June 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive at Glastonbury Health Centre on 20 November 2018 as part of our inspection programme.

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 that care and treatment was delivered according to evidence- based guidelines.
• Feedback from local care and nursing home services demonstrated that the practice worked well with them and provided support in the interest of the best outcomes for patients.
• The practice provided comprehensive support for patients with mental health needs, personalised long-term care plans were in place and they worked well with other mental health professionals with a ‘shared care’ approach.
• 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 a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice has continued working with endeavouring in reducing their impact on the environment with a ‘Green Impact’ policy and ways of working. Recently working with a Deanery Scholarship Registrar, they had been looking at changes they could do to reduce paper use, recycling inhalers and providing energy advice to patients.

The areas where the provider should make improvements are:

• The provider should continue with developing aspects of well led with a central oversight of staff’s immunisation status, training for staff in respect of fire safety and trained fire marshals to maintain safety, monitor that their recruitment policy and procedure is followed.
• The provider should make changes to their registration with CQC in a timely way.
• The provider should continue to monitor cervical smear screening to meet Public Health England screening rates.
• The provider should continue to monitor childhood immunisation to meet Public Health England immunisation rates.

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

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Glastonbury Health Centre Surgery on 10 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. It was also good for providing services for older people, people with long-term conditions, mothers, babies, children and young people, the working-age population, including students and those recently retired, people in vulnerable circumstances who may have poor access to primary care and people experiencing poor mental health.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• The practice worked well with other services to provide treatment and support for patients who have a diagnosis of a mental healthcondition.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they were able to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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 practice are one of five practices nationally that have a PMS plus contract for Complementary Services (osteopathy and acupuncture). This service has met the need for effective alternative therapy and reducing referrals to conventional therapists (physiotherapists/orthopaedics) for chronic muscular skeletal pain. This service meets their patient group expectation for complementary therapies and NICE guidelines.

We saw several areas of outstanding practice including:

• The newly developed Health Connections Mendip service which was partly facilitated by Glastonbury Health Centre and another local medical practice, to build patient confidence and self- reliance in managing their own conditions and use services available to them for support.
• The practice has a programme in place to avoid unplanned admissions to hospital.
• Daily same day clinics with a medical team consisting of GP and Nurse practitioner are provided. The Extended Surgery service offers appointments with GPs, Nurses and HCA 6.30 pm to 7.15pm one evening per week.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice