Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ryalls Park Medical Centre on 28 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.
• 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.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health. All these patients had received a telephone call from a health coach within three days of their admission.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP, although found it difficult to get through on the telephone. There was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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 provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

The practice held a meeting (a ‘Huddle’) twice every day, with the whole team involved. They used this time to look at current information that had been received, how it may impact on patient care and how best to address patients’ needs on the day. This information was also used to decide whether more appointments needed to be made available on the day; for forward planning of appointments; and to check any new information received against other agency records to ensure no patients were missed. Actions were agreed, patient records were updated during the meeting and information was shared with other members of the community multi-disciplinary teams.

The areas where the provider should make improvement are:

• The practice should continue to improve telephone access . The last patient survey showed only 54% of patients said they could get through easily to the practice by phone compared to the national average of 73%.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with the practice manager about their action plan following out last inspection on 4 February 2014 which highlighted recruitment processes which fell below the required standards. The practice manager told us they reviewed their recruitment policies and had made significant changes to their processes for recruiting new staff.

The policies they provided to us were detailed and showed a clear recruitment pathway from advertising a vacancy through to post employment induction training. We saw there were sufficient checks in place to ensure robust and effective recruitment took place.

Patients were treated with consideration and respect. We spoke with six patients. One patient told us, “I’m happy with the way I’m spoken to here. I have no issues with that.”

Patients’ spoke positively about the care they received at the medical centre. One patient said, “I have nothing but praise for the place.” Another patient said, “I’m really very happy with the surgery.”

People who used the medical centre, staff and visitors were protected against the risks of unsafe or unsuitable premises.

The provider carried out a number of pre-employment checks to ensure that staff had the necessary skills and experience. However, the current system used by the medical centre did not ensure staff were of good character prior to them commencing employment.

The medical centre had suitable systems to monitor the quality of the service provided.