Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Haslemere Health Centre on 9 March 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. There was a broad skill mix amongst the staff.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice took a proactive approach to providing care for patients most at risk of admission to hospital.
• The practice had developed a robust repeat medication system to ensure the appropriate reviews had been carried out where required.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day. There was a daily minor ailments clinic.
• 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.
• The practice had a very well developed bespoke intranet system which contained referral forms and pathways making it easy for the GP to access up to date information and coordinate care.
• The practice had recently employed a pharmacist who reviewed medication for patients discharged from hospital and provided a source of expertise for the practice.

We saw several areas of outstanding practice:

• The practice had established a joint clinic with the practice nurse and vascular consultant allowing prompt and expert assessment of patients at potential risk of joint amputation. This early prioritisation had identified three patients who were at risk of significant loss of limb.
• The practice provided pulse checks at the annual flu clinics and as a result identified 2.1% of their population as having atrial fibrillation, against a national average of 1.6%.

The area where the provider should make improvement is:

• Review the arrangements for ensuring that patients with long term conditions receive high quality care in light of the high level of exception reporting in the Quality and Outcomes Framework.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with six people who used the service on the telephone. They had attended the practice on the day of our inspection for an appointment. These patients were randomly selected. We spoke with staff that included; the practice manager, three practice nurses, a receptionist and the registered manager, who was the lead general practitioner (GP). We also spoke with the representative of the Patients Participation Group (PPG).

We used a number of different methods to help us understand the experiences of people who used the service. We spent time talking with people and observing the interactions between staff and people. We reviewed records and systems.

When registered the provider declared compliance with all outcome areas.

We found that people were treated with respect and had treatment options discussed with them. People felt involved in their care and treatment.

We saw that there were effective infection control measures in place to prevent the spread of infection.

We looked at the processes that the practice had in place to ensure the people who used the service were protected from abuse. These processes ensured staff had an understanding of adult and child abuse and what to do if it was suspected.

We found that people understood how to make a complaint or how to raise concerns. They were helped to complete this process if necessary. The provider responded to complaints and kept these under review.