Letter from the Chief Inspector of General Practice

Dr DS Walsh and Partners is situated in the inner city area of Bristol with approximately 9797 registered patients. We undertook a comprehensive announced inspection on 2 December 2014. Our inspection team was led by a Care Quality Commission (CQC) Lead Inspector, a practice nurse specialist advisor and GP specialist advisor.

Before visiting, we reviewed a range of information we held about the practice and asked other organisations to share what they knew. This included the Bristol Clinical Commissioning Group (CCG), NHS England and Healthwatch.

Our key findings were as follows:

• Patients were able to get an appointment when they needed it.
• Staff were caring and treated patients with kindness and respect.
• Staff explained and involved patients in treatment decisions
• Patients were cared for in an environment which was clean and reflected good infection control practices.
• The practice had the appropriate equipment, medicines and procedures to manage foreseeable patient emergencies.
• The practice met nationally recognised quality standards for improving patient care and maintaining quality.
• The practice had systems to identify, monitor and evaluate risks to patients.
• Patients were treated by suitably qualified staff.
• GPs and nursing staff followed national guidance in the care and treatment they provided.

We saw an area of outstanding practice:

• The practice worked in partnership with a substance misuse and alcohol rehabilitation project to offer a shared care treatment service to a considerable number of patients. This joint working led to other treatment being made accessible, for example, a nurse led drop in clinics enabled patients who were intravenous drug users to access treatment for wounds.

However, there were also two areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure there are systematic processes in place for the safe management of medicines

In addition the provider should:

• Ensure that staff understand and implement the practice’s agreed protocols and procedures for dealing with incidents and emergencies
• The practice should have a patient participation group.

Professor Steve Field CBE FRCP FFPH FRCGP

Letter from the Chief Inspector of General Practice

We undertook a comprehensive announced inspection on 2 December 2014. Overall the practice is rated as good for providing an effective, caring, responsive and well led service; however, at the December inspection the practice was rated as requiring improvement for the safe domain. This was because the arrangements for the recording and monitoring of medicines used for the purpose of the regulated activity were ineffective to ensure patient safety. We carried out a focused inspection on 8 September 2015 to review the action the provider had taken to address these issues.

Our key findings were as follows:

• The provider had reviewed and improved the arrangements for the recording and monitoring of medicines.

• The provider had ensured that staff understood and implemented the practice’s agreed protocols and procedures for dealing with incidents and emergencies and accessed additional training resources to support staff learning.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We inspected Dr Walsh and partners on 12 November 2013. We spent the day at the surgery looking at records and speaking with people. We spoke with six patients, three practice nurses, a health care assistant, practice manager and a GP who was also a partner.

We spoke with patients who were visiting the surgery. Patients told us they were happy with the service they received. Patient comments included; “I usually see the treatment room staff, they are alright and I can usually get an appointment”. “They are very busy but they are doctors”. “Sometimes they can be late but they often tell us. It can’t be helped sometimes”. All the patients we spoke with told us the doctors understood their needs.

The provider had systems in place for monitoring the quality of the service provision. There was an established system for regularly obtaining opinions from patients about the standards of the services they received. This meant that on-going improvements could be made by the practice staff.

The practice offered a culturally aware service to a diverse population. Staff who worked at the practice were knowledgeable about the cultural needs of their patients, both from a medical and sociological perspective.