Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park House Surgery on 30 November 2016. Overall the practice is rated as good.

• A system was in place for reporting and recording significant events, keeping these under review and sharing learning where this occurred.

• Risks to patients were assessed and well managed.

• Systems were in place to deal with medical emergencies and all staff were trained in basic life support.

• There were arrangements in place to safeguard adults and children from abuse that reflect relevant legislation and local requirements. Staff understood their responsibilities and adhered to safeguarding policies and procedures. However safeguarding meetings with other health professionals was not taking place.

• The standard of cleanliness and hygiene was good. Reliable systems were in place to prevent and protect people from a healthcare associated infection. These systems were monitored with regular infection control audits.

• The arrangements for managing medicines, including obtaining, prescribing, recording, handling was safe but the storage of prescription pads required improving.

• 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.

• Feedback from patients about their care was consistently positive. We saw good communication with patients from staff so that they understood their care, treatment and condition.

• Information about services and how to complain was available and easy to understand. We found openness and transparency about how complaints and concerns were dealt with. Lessons were learned from concerns and complaints, and appropriate action taken as a result to improve the quality of care. These lessons were shared with all staff.

• Patient’s feedback for the new triage appointment system was mixed. Some reported concerns that this system was not always convenient and others stated they were happy to consult with the GP via telephone rather than a face to face appointment.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was a programme of clinical and internal audit, which was used to monitor quality and systems to identify where action should be taken.

• While the practice had experienced a shortage of GPs the review of management systems had not been undertaken regularly. At the time of the inspection the practice was in the process of developing and implementing an assurance system and service performance measures, which we were informed, would be reported and monitored to improve performance.

There were also areas of practice where the provider should make improvements. The provider should:

• Improve the care plans in place for patients with complex health needs, who are at high risk of avoidable unplanned hospital admissions.

• The security of prescriptions should be reviewed as some were left in printers in rooms which were not locked.

• Encourage an interagency approach to safeguarding patients including regular communications and safeguarding meetings.

• Review the records made of the monthly multi-disciplinary meetings to ensure sufficient detail is made.

• Review the GP patient survey results that showed 43% of patients found it easy to get through to this practice by phone compared to the CCG average of 65% and the national average of 72%.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice