Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Chads Surgery on 23 November 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 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 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 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.
• 83% of patients said they could get through easily to the practice by phone compared to the national average 73%.
• 93% of patients were able to get an appointment to see or speak to someone the last time they tried compared with the national average of 85%.
• The patient participation group (PPG) was well engaged and represented across a diverse range of ages and backgrounds. The PPG suggestions for changes to the practice management team had been acted upon and the group had raised awareness to patients about the practice’ services.
• The practice participated in a social prescribing scheme to support people who attend their GP surgery but did not necessarily require medical care. Social prescribing supported patients with issues such as social isolation and coping with caring responsibilities, to connect to services and groups that could help improve their wellbeing and meet their wider needs.
• Results from the NHS Friends and Family Test showed that 467 respondents (94%) would recommend the practice to family and friends.
• Staff had lead roles that improved outcomes for patients such as a carer’s lead.
• 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.
• When there were unintended or unexpected safety incidents, patients received reasonable support, truthful information, a verbal and written apology and were told about any actions to improve processes to prevent the same thing happening again.
• The practice hosted a talking therapy service for patients who had experienced bereavement, were carers, or were experiencing mental health issues. The service was funded by the local clinical commissioning group (CCG) and was available on referral.

We saw three areas of outstanding practice:

• There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that met these needs and promoted equality. St Chads Surgery identified patients at risk of developing diabetes who were not on the diabetes register, and implemented changes that could help to delay or prevent the progression of this health condition. Changes offered to patients included lifestyle interventions and annual blood testing. The practice identified 138 patients who were not on the diabetes register and the practice developed a new information technology template to record their needs.

• The practice developed a ‘tiered letter recall system’ so that patients need only attend one annual review to address multiple health concerns. For example, 783 patients with diagnoses of diabetes, chronic kidney disease and hypertension had these health issues addressed in a single annual review in the last year.
• In 2015 and 2016, the practice received an award from the National Institute for Health Research (NIHR). The reward recognised the practice for developing innovative models of recruitment, and for consistently delivering its research findings to time and on target.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice