We carried out an announced comprehensive inspection at New Silksworth Medical Group on 24 January 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall but as requiring improvement for the provision of responsive services and for all population groups.

The practice is rated as good for providing safe, effective, caring and well led services as we found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• The practice was performing well in ensuring eligible patients had a cervical smear test. A practice nurses who acted as learning disability lead and was proactive in encouraging female patients with a learning disability to undergo cervical smear tests. This was facilitated by giving learning disability patients a longer appointment time and a detailed explanation of the process. In addition cervical smear invitation letters were sent on pink paper to encourage uptake.

The practice is rated as requiring improvement for the provision of responsive services and for all population groups as:

• Patient satisfaction in relation to accessing care and treatment in a timely way was poor. There was a pattern of negative patient feedback in relation to the overall experience of making an appointment and appointment availability which adversely affected all patient population groups.

We saw an example of outstanding practice:

• The practice had carried out a comprehensive review of policies, procedures and templates to include a list of appropriate investigations for each long-term condition. The updated templates had been shared with other practices in the area by the local Clinical Commissioning Group as best practice guidance and a service level agreement requirement.

However, the provider should:

• Take steps to improve access to appointments and address patient dissatisfaction in relation to this.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice