Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Glebe House Surgery on 5 November 2015.

Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• All staff were actively engaged in activities to monitor and improve quality and outcomes. The continuing development of staff skills, competence and knowledge was recognised as integral to ensuring high-quality care.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment was mixed. The data was mostly above the national average but mostly below the CCG average in this area. People we spoke with on the day were able to get appointments although some said it was difficult to get through on the telephone and waiting times for pre-arranged appointments was sometimes lengthy, up to 45 minutes.
• Extended hours surgeries were offered by one or two GPs two evenings per week from 6.30pm to 8pm, normally on Mondays or Thursday or on occasion the extended hours take place on other weekdays or a Saturday.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG). For example, the PPG had been influential in arranging for the installation of new more accessible front door. The group had also published an information leaflet including how to book an appointment and how to order repeat prescriptions. The two PPG members we met with told us the practice listened and acted.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• 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 several areas of outstanding practice including:

• The practice provided numerous in house services and tests that would normally be undertaken in hospital as part of locally negotiated ‘out of hospital services bundle’. These services meant patients could be treated closer to home and this was of significant benefit to the patients.

• The practice demonstrated their commitment to working collaboratively, and they explored and implemented innovative and efficient ways to deliver more joined up care to people who used services. A recent example of this was the work the practice had carried out as part of the Primary Care Nursing Development Project (nursing project). The aim of the project was to develop primary care nursing, improve access of housebound patients to services and break down barriers between practice, community and nursing home nurses.

The areas where the provider should make improvements are:

• Ensure systems are in place to reduce patient waiting times for pre-booked appointments.
• Review access to appointments via the telephone system.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice