Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Regent House Surgery on 27 April 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. All opportunities for learning from internal and external incidents were maximised.

• 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.

• Risks to patients were assessed and well managed.

• Staff had been trained to provide 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.

• The practice had a number of policies and procedures to govern activity and held regular governance meetings. The practice had strong and visible clinical and managerial leadership and governance arrangements.

• Staff demonstrated a good understanding of the issues relating to safeguarding vulnerable adults and children.

• The provider and staff were aware of and complied with the Duty of Candour regulation. The Duty of Candour places a responsibility on providers to be open and honest with service users about their care and treatment, including when it goes wrong.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Audit and quality improvement work demonstrated improved outcomes for patients, although some were not two cycle audits.

We saw several areas of outstanding practice:

The practice offered services to other practices such as substance misuse, ophthalmology and physiotherapy. The practice provided Doppler screening to check for deep vein thrombosis (DVT) (A Doppler is an ultrasound test to check the blood flow through the arteries). This helped to reduce hospital appointments and admissions and initiated treatment when required.

The practice carried out a medicines audit that identified not all patients prescribed Methotrexate were being appropriately monitored during Rheumatology outpatient appointments. (Methotrexate is a medicine prescribed to treat Rheumatoid Arthritis). One of the GPs produced a simple method of collecting data by producing slips which patients must complete before being issued with a repeat Methotrexate prescription. This meant that patients did not need additional hospital appointments to monitor this medication.

The practice maintained a register of patients with a learning disability. They were offered a yearly review with the lead nurse. Health action plans with personalised goals had been designed for the patients, including pictorial health action plans for patients with a learning disability.

GPs had implemented a system of peer reviews that included videoing each other's consultations with the aim of improving practice.

The practice had taken part in several charity events which benefitted the local community and maintained positive and proactive engagement not only with the practice population but also the wider community.

There was one area where the provider should make improvement:

• Implement a more structured system to support two cycle audits to demonstrate a complete audit process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice