Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park Surgery on 28 October 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 within the practice. Effective systems were in place to report, record and learn from significant events. Learning was shared with staff and external stakeholders where appropriate.

• Risks to patients were assessed and well managed. Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• GPs worked collaboratively with neighbouring practices in their locality area in planning services to suit their population in order to achieve better health outcomes for patients across the locality.

• The practice demonstrated a caring approach by hosting a monthly carer’s clinic offered by a local carer’s organisation. There were three members of staff who were trained as carer’s champions including a dementia champion.

• The practice provided anticoagulation clinics which were run flexibly to accommodate all patients and home visits were offered to housebound patients. Patient feedback was sought on the service which indicated positive outcomes for the patients.

• Training was provided for staff which equipped them with the skills, knowledge and experience to deliver effective care and treatment.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Patients told us they were able to get an appointment with a GP when they needed one, with urgent appointments available on the same day.

• 99% of patients stated they had confidence in the last GP they saw or spoke to.

• 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 and learning from complaints was shared with staff and stakeholders.

• The practice had good facilities and was well equipped to treat patients and meet their needs. Services were designed to meet the needs of patients.

• 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 partners held an annual business review meetings where all staff were involved, with a half yearly review.

• There was evidence of close partnership working with the patient participation group (PPG) who undertook annual patient surveys to gather feedback from at least 500 patients each year to obtain a wide range of views on the quality of services provided.

We saw an outstanding feature:

• The practice was proactive in identifying and supporting patients with long term conditions such as chronic kidney disease and atrial fibrillation. For example, they purchased their own device which was used to screen patients opportunistically at flu clinics. As a result, 129 patients were screened and 14 of these were found to have symptoms which instigated further investigation. One patient received a confirmed diagnosis whilst the others were waiting for their reviews to be completed. The practice produced an in-house information leaflet on the management of chronic kidney disease. On the back of the leaflet was a log of checks which was personalised to help both the patient and the GP to monitor kidney function

The areas where the provider should make improvements are:

• Take steps to identify more carers in order to support them where appropriate.

• Take more proactive steps to ensure patients with a learning disability have an annual health check.

• Explore the reasons for higher exception reporting in some areas and consider actions which could be taken to improve this to ensure patients health and wellbeing

• Continue to take steps to improve access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice