This practice is rated as Outstanding overall. (Previous inspection August 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Outstanding

Are services responsive? – Outstanding

Are services well-led? - Outstanding

We carried out an announced comprehensive inspection at Silverdale Family Practice on 15 November 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice consistently reviewed the effectiveness and appropriateness of the care it provided. It ensured care and treatment was delivered according to evidence based guidelines.
• Feedback from patients who used the service, those close to them and external stakeholders was continually positive about the way staff cared for patients.
• Patients found the appointment system easy to use and reported access to appointments was good, staff confirmed this.
• Leaders had the capacity and skills to deliver high-quality, sustainable care. They had an inspiring shared purpose, strived to deliver and motivated staff to succeed.
• Staff told us they felt supported and engaged with managers and there was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The practice participated in the Healthier and Wealthier scheme where free benefits and welfare advice was given to patients. The clinicians identified patients in need of advice and arranged a call-back with a trained adviser. As a result of this patients with a ‘financial outcome’ were on average £3,713 better off. Twenty patient’s ‘Warwick-Edinburgh’ score (a tool used to assess patients’ mental wellbeing) improved from an average of 2.38 to 3.25 (out of 5) after they had received the advice.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out this comprehensive inspection on 12 August 2015.

Overall, we rated this practice as good. Specifically, we found the practice to be good for providing safe, effective, caring, and well led services. It was outstanding for providing responsive services. It was also outstanding for providing services to the population group of people with long term conditions.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. As well as responding to incidents and concerns within the practice the GPs had raised concerns relating to care in other health settings, which had affected its patients, to ensure that these were reviewed and the learning circulated.
• There were systems in place to reduce risks to patient safety for example, infection control procedures.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that 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.

We saw several areas of outstanding practice including:

• The practice was integrated into the local community and attended events at the local school and invited reception class children to visit the practice. This made the GPs and clinical staff approachable and helped to minimise concerns felt by children if they had to visit the GP.
• The practice was working innovatively with the North East Ambulance Service and NHS 111 service to monitor the health of patients with chronic obstructive pulmonary disease (COPD). The ambulance service paramedics would make daily telephone calls check on the patient’s condition and to book appointments with the practice as required. This helped to minimise A&E attendances and the use of urgent care centres.
• The practice was responsive in the way it delivered care to patients with learning disabilities and one of the GPs undertook a half-day session to visit the homes of patients with learning disabilities to undertake their annual health checks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Patients told us they were always treated with care and respect. One person said, "All three are really good doctors." Patients told us their views were listened to and their needs were fully met. We were told they could get an appointment easily and the reception staff were "very friendly."

Staff we spoke with understood the safeguarding procedures for adults and children.

We saw the practice actively sought the views of patients through comments and a very active patient participation group. We saw changes to the service had been implemented as a result of patient feedback.

We saw the practice was up to date with infection control policies and procedures. When we spoke with staff they had a clear understanding how to reduce the risk of cross infection. The surgery was clean and well maintained.

Staff were provided with support, guidance and training to make sure they were able to carry out their role safely.

Care and treatment was planned and delivered in a way that ensured people’s safety and welfare.

We saw that the general practitioners were following national guidance as well as local Clinical Commissioning Group guidelines to make sure they were using best practice guidance.