Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Havelock Grange Practice on 12 May 2016. 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.

• 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns. The practice promoted a no blame culture and encouraged staff to raise concerns and possible risks.
• The majority of patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. However seven patients said they had difficulty with telephone access and appointments.

• Feedback from patients about their care was consistently positive.

• 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 three area of outstanding practice:

• The practice employed part-time pharmacists to improve their service to patients and have recently employed a further part-time pharmacist. Following a review of the pharmacist role it was identified that is has saved 2.5 sessions of GP appointments per week undertaking different functions which the practice expect will increase with the additional pharmacist. Examples of the work undertaken were medicine reviews, face to face and telephone consultations and the checking of all discharge summaries for any medication errors. The pharmacist has also produced policies which have been rolled out across the CCG area.

• During 2015 – 2016 the practice demonstrated a saving of £19,757 from reducing medication waste. Examples of these were reviewing prescriptionsand working with prescription clerks and local pharcies. During this period there was only one pharmacist working part-time in the practice. They hope to increase savings with the employment of the second part-time pharmacist.

• The practice provided a non-judgemental approach in welcoming transgender patients, homeless and drug and alcohol patients. The practice had reviewed their policies to remove some of the barriers these patients sometimes encounter when registering with a practice. Examples of these were not asking for proof of an address and ensuring transgender patients were addressed always by their chosen name.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice