Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park Medical Centre on 6 September 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Safety alerts were received and acted upon.
• Risks to patients were assessed and well managed.
• 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.
• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.
• Infection control procedures were in place.
• 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.
• Patients said that sometimes they had difficulty making appointments with a named GP and telephone access was variable. However urgent appointments were available the same day for children and those patients who needed them and national patient survey results did not indicate a concern in accessing appointments.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear approach to working with others to improve care outcomes with a clear strategy and objectives including engaging with other key partners in providing health services.
• There was a clear leadership structure and staff were well supported by the GP partners.
• Staff were supervised, felt involved and worked as a team.
• The provider was aware of and complied with the requirements of the duty of candour.

There were areas of practice where the provider should make improvements, these were:

• Review the monitoring of the cleanliness of the premises to include documenting adherence to the cleaning schedule.

• Review the system for obtaining and acting on patient feedback to include reviewing results and acting on issues raised by any external surveys (such as the national GP patient survey). Review the contribution of internal surveys for obtaining feedback and suggestions.

• Review the access to safeguarding policies and procedures to include having practice specific policies and procedures available for staff.

• Review their governance arrangements to include annual or more frequent review of complaints and significant events to identify themes and trends.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Park Medical Centre registered the Shavington Avenue Surgery with CQC, as responsible for providing primary care, which includes access to GPs, minor surgery, family planning, ante and post natal care. The practice provides a weekday service for over 8800 patients in the Chester area and is open Monday to Friday from 08:30 to 18:30. Patients can book appointments with Western Cheshire Extended Hours Service, which runs services until 10 pm every week day and 10 -12 am on a Saturday, by contacting staff at the Shavington Avenue Surgery. Western Cheshire Out of Hours offers a service for patients who need urgent care overnight.

The practice is registered with the Care Quality Commission to deliver the regulated activities:

• Diagnostic and screening procedures
• Family planning
• Maternity and midwifery services
• Surgical procedures
• Treatment of disease, disorder or injury

The 12 patients we spoke with and one person who completed our comment cards were extremely complimentary about the care and treatment being provided. Patients reported that all the staff treated them with dignity and respect. They found the doctors and nurses delivered a very personalised service and had an excellent understanding of their needs.

The staff could show us how they actively listened to patient comments and taken action on the back of these to improve their service.

Staff were responsive to patients’ needs. Patients could phone during the day and a GP would call them back within an hour to discuss their problem. The practice actively monitored patients and made arrangements for patients who had conditions that needed to be regularly reviewed to attend the practice for routine checks.

The building was well-maintained and very clean. Effective systems were in place for the oversight of medication. Clinical decisions followed best practice guidance.

We found that the leadership team was very visible. There were good governance and risk management measures in place.

We found that the practice had met the regulations and provided services that were safe and effective.