Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grove House Surgery on 11 February 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Opportunities for learning from internal and external incidents were maximised.
• Risks to patients were assessed and well managed.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice was piloting a Medication Safety Alert scheme for Somerset.
• 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.
• Feedback from patients about their care was consistently positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients told us that staff went the extra mile and the care that they received exceeded their expectations.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, the practice was using the recently published Public Health Profile to identify future priorities; and was actively using the services of Health Connectors to meet social as well as clinical needs of patients.
• 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.
• Patients said they found it easy to make an appointment, with urgent appointments available the same day. However, due to clinical staffing levels it was more difficult to book routine appointments in a timely way or to provide continuity of care.
• 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.

We saw several areas of outstanding practice including:

• Patients were advised and supported to access a wide a range of self-help, social prescribing and community based schemes.
• The practice had identified more patients who acted as carers than was typically achieved. A member of staff acted as a carers’ champion to help ensure that the various services supporting carers were coordinated and effective.
• We saw positive patient feedback from a variety of sources, including The Friends and Family Test, indicating better than average satisfaction across several areas of activity.
• The practice had developed in house counselling services to address waiting times for NHS services and provide longer term support.
• The practice had streamlined diabetes care including patient recall and appointment arrangements that allowed patients to focus on priorities.

The areas where the provider should make improvements:

• Review emergency medicines to ensure all appropriate medicines are available.
• Review clinical capacity and the arrangements for appointments to reduce reliance on locums and increase the available number of pre-bookable appointments.
• Review the security of patient records.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice