Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Leadgate Surgery on 2 February 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. The practice had developed a clinical system that identified a wider range of patients at risk of harm including those at risk of domestic violence and those at risk of harming themselves.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned. For example, administration and reception staff had received extra training in answering the telephone and clinical staff in motivational interviewing.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Feedback from patients about their care was consistently and strongly positive.
• Patients said they found it easy to make an appointment. There were urgent appointments available the same day for GPs and Nurses. Routine appointments were available to book in four days; telephone consultations were available the same day.
• 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 the management team. The practice proactively sought feedback from staff and patients, including the Patient Participation Group (PPG).
• Information about services and how to complain was available and easy to understand.

We saw several areas of outstanding practice:

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, one of the GPs had created the Derwentside Clinical System (DCS) in Primary Care which was a function in the computer system that bridged the gap between guidance and implementation. This system had been recognised nationally and adopted by 70 other organisations. The system ensured that patients received the right treatment at the right time. It eliminated duplication of tests and helped ensure patients did not miss any recalls.

• The practice encouraged a culture of innovation and improvement; staff were encouraged to increase their knowledge and skills. The apprentice at the practice had won an award from Derwentside College in November 2015; this was ‘Excellence in Business Administration Apprenticeship’.

• There was a strong focus on early identification and prevention of disease and long term conditions. The practice had proactively monitored patients at risk of diabetes since 2009 and had received funding from Public Health England following a proposal they made. This was to implement a more comprehensive system for diabetes prevention and began in May 2015 based on NICE guidance. This had demonstrated very significant results in identifying undiagnosed impaired glucose regulation (patients at risk of developing diabetes).This approach had now been rolled out to five other local practices with the support of the local Public Health Department and NHS England. Data showed that diabetes prevalence at the practice was lower than similar practices in the area but the register of patients at risk who were being monitored was much higher. Therefore these patients had the benefit of early identification and treatment if necessary.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Leadgate Surgery on 6 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.