Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Siam Surgery on 24 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 and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Patient safety alerts were logged, shared and initial searches were completed and the changes effected.
• 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.
• 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 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 and 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 with a relaxed and friendly management style, and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider should make improvement are:

• Review the chaperone policy and procedure and the arrangements for documenting written patient consent for invasive procedures.

• Following the practice's own audit work, drive work forward to ensure that patients on warfarin are identified and reviewed as appropriate.
• Ensure that portable appliance testing (PAT) is completed in accordance with the practice risk assessment.
• Ensure that patient’s privacy is maintained whilst using the minor surgery room.
• Ensure that written information on the practice’s complaints policy is available in the waiting room.

We saw one area of outstanding practice:

• The practice nurse contacted every patient who had been diagnosed with cancer to provide support and advice on local support services and benefits. Peripherally inserted central catheter (PICC) line care was also offered to patients to reduce the need for them to travel to West Suffolk Hospital. PICC is a form of intravenous access that can be used for a prolonged period of time, for example for patients receiving long term chemotherapy.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice