Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Market Cross Surgery on 10 November 2016. Overall the practice is rated as outstanding. The practice is rated as good for providing safe, effective and well led services and outstanding for providing caring and responsive services.

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

• There was an open and transparent approach to safety and the practice had systems in place for reporting and recording significant events.
• The practice was proactive and responsive to patient’s needs.
• Data from the national GP patient survey showed patients rated the practice higher than the CCG and national averages for several aspects of care.
• The practice had identified 216 patients as carers (2% of the practice list).
• Patient safety alerts were logged, shared and searches were completed to ensure reviews of patient care took place where necessary.
• 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. However some e-learning training was overdue.
• 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 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.
• Due circumstances beyond their control and to IT problems during a change to their computer system, the practice performance in some areas of the quality and outcome framework were below the CCG and national averages.

The areas where the provider should make improvements are:

• Monitor printer prescription form logs to ensure they are tracked throughout the practice and improve the measures for the security of controlled drugs.
• Monitor the fridge temperature logs to ensure that dispensary staff have understood the cold chain training given to them.
• Ensure the practice has an up to date fire risk assessment and any identified actions are completed.
• Review staff training ensuring all staff are up to date with training appropriate to their role and needs.

Outstanding elements;

• A young people’s guide to the Market Cross surgery was written and available to patients which included advice on managing stress, healthy weight, contraception, smoking cessation, sexual health and travel advice. It included links to websites and various schemes, the guide was written in a clear colourful leaflet. The leaflet also included information on confidentiality to help young people to have confidence to speak with clinicians at the practice.
• The practice recognised that they served a hard to reach population of patients who may be marginalised. They engaged with the local travelling community and had achieved positive outcomes. They recognised that this group of patients often respond better to verbal and pictorial information and with the community helped develop a health education DVD, including health promotion subjects. The practice were proactive in undertaking data searches for this group of patients to identify gaps in public health measures, such as childhood immunisation and men’s health. Furthermore, to increase engagement with health outcomes for men and women of all ages of the travelling community, there was a plan in place to house an on-site fixed cabin where outreach services could be supplied. A member of the patient participation group who was from the travelling community supported this.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice