Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Schopwick Surgery on 19 December 2016. Overall the practice is rated as outstanding.

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 and the practice sought to continually improve processes.
• 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.
• 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.
• The practice had invested significant resources into improving and expanding access. This included the provision of extended opening times and an innovative virtual surgery.
• 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.
• Clinical staff proactively shared decision making with patients. This meant patients had input into their condition management plans as a strategy to help empower them to improve their health.
• There was a consistent, overarching focus on health promotion and educating patients to live healthier lives as part of a collaborative relationship. A dedicated carers’ champion and resource centre, and bi-annual healthy living events helped to embed this in practice and there was evidence of improved patient outcomes as a result.
• The practice was proactive in providing palliative care and support for patients in line with the national Gold Standards Framework. This was one example of a substantial range of multidisciplinary relationships and initiatives that the practice proactively sought to develop to meet the needs of its patients.
• There was a focus on continuous learning and improvement at all levels within the practice. The practice team was forward thinking and part of local pilot schemes to improve outcomes for patients in the area.
• An innovation lead GP was in post who provided support to staff to improve patient care and reduce health inequalities in the local population. Recent innovations had been rewarded and recognised by national bodies, which was indicative of the commitment and passion of the practice team.

We found areas of outstanding practice:

• A GP acted as the dedicated lead for IT development and patient engagement through social media. The virtual surgery provided patients with direct access to health advice and guidance and enabled them to get a fast response from a GP for non-urgent conditions.
• The practice had been recognised nationally for its innovative work in supporting carers and in developing a community navigators programme. This led to the practice staff being awarded a Health Service Journal Value in Health Care Award in 2015. In addition, the housebound project was recognised by the Royal College of General Practitioners (RCGP) and staff were selected to present their work at the annual conference in 2016.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We found the service at both surgeries, Elstree and Bushey to be welcoming with friendly staff. Information was displayed for people who used the service, including information about the practice, health promotion and access to support and other services. There was a touch screen booking in facility near the reception area and appointments could be made on line using the practice website.

People had a choice of attending either of the two surgeries. All the staff, doctors, nursing and administration staff members rotated between both the surgeries.

We spoke with seven people who used the service. All spoke highly of services provided to them. We also spoke with staff members who said they enjoyed working in the practice and felt supported by their peers and their line managers.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual wishes. One person said, "Everyone is very nice here. I see the nurse quite a lot and she is really kind." Another person said, "My doctor really listens and doesn’t fob me off because I’m old.”

We saw that there was a system to ensure repeat prescriptions were available promptly and medicines that were kept at the practice were stored safely.

The practice had an electronic records system, which was used by all staff. Paper records received from other areas, when people changed practices were stored safely.