Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students) – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Pringle Street Surgery on 24 January 2018. This was the practice’s first inspection and was carried out as part of our commitment to inspecting and rating all GP practices in England.

At this inspection we found:

• The practice ensured that care and treatment was delivered according to evidence- based guidelines and reviewed the effectiveness and appropriateness of the care it provided.

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice documented investigations resulting from them and improved their processes.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• The practice demonstrated awareness of the specific cultural needs of its patient population.

• Staff felt respected, valued and supported and were able to give us examples of how the practice had listened and acted on their feedback.

• The practice engaged positively with integrated working alongside other professionals. Regular multidisciplinary team meetings took place to ensure person-centred care was delivered to patients.

• Quality improvement issues were discussed in regular staff meetings. Clinical matters were discussed in monthly meetings.

• There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice showed us how it engaged in local pilot schemes and could demonstrate how it had improved patient outcomes, for example by improving the uptake of cervical smear screening.

We saw one area of outstanding practice:

• The practice engaged with other healthcare professionals to facilitate improved care for its patients. For example it worked with an ‘Achieving Self Care’ facilitator who was employed by a local hospital trust and attended the surgery once per week on a Tuesday to support patients who experienced mild – moderate mental health difficulties. Since November 2016 the practice had referred 59 patients to this service, with 38 of these benefitting from improved mental wellbeing as measured by the Warwick-Edinburgh Mental Wellbeing Scale (a tool for measuring a person’s mental wellbeing).

The areas where the provider should make improvements are:

• Clinical oversight of the management of incoming correspondence should be sufficient to ensure the system is working safely and effectively.

• Staff should be aware of policy and procedure documents relating to the work they undertake. These documents should be sufficiently detailed to describe the activity being carried out.

• Complete mitigating actions in line with documented risk assessments, for example in relation to legionella.

• The complaints procedure should be readily available to patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice