Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Staithe Surgery on 19 April 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The appointment system was flexible and ensured that patients who requested to be seen on the same day were.
• The practice had good facilities including disabled access. A hearing loop was available for those patients who needed it. Patients that were particularly unwell were asked to wait in areas where reception staff could observe them, in case their condition changed.
• Information about the services and how to complain was available. The practice sought patient views about improvements that could be made to the service and some of these discussions occurred through the patient participation group (PPG).
• The practice proactively managed care plans for vulnerable patients and had effective management strategies for patients at the end of their life.
• There were systems, policies and procedures to keep patients safe and to govern activity for example, infection control.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• The practice produced a newsletter each quarter to ensure that patients were kept up to date with any changes at the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Staff told us that patients were respected and involved. All the consulting rooms were located away from the waiting areas so that consultations were private and confidential. Health professionals discussed all treatment and care options with patients so that they understood what options were open to them. Information leaflets were given to patients so that they were well informed with up to date information. One patient told us, “It’s the best I’ve ever been to.” Another patient said, “I would definitely recommend them. They explain things.” Another patient told us, “It’s a brilliant surgery.”

Computerised records were kept to a consistent standard and clear information about consultations was recorded. The new patient registration system ensured that patients with on-going health and medication needs were seen quickly and did not have their treatment regimes interrupted. People who were not able to attend during the day were able to arrange a consultation at the evening surgery that was held on a Wednesday. People told us that they did not have difficulty in getting an appointment that suited them.

A range of audits were taking place that assessed the quality of the service. These included prescribing and medication audits and specific treatment regimes. There were mechanisms in place to investigate incidents, with action being taken as necessary. People told us they knew how to complain and they felt they would be listened to.

We carried out an announced comprehensive inspection at Stalham Staithe Surgery on 19 March 2019 as part of our inspection programme. The practice was previously inspected in June 2016 and rated as good overall.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

This means that:

• People were protected from avoidable harm and abuse and that legal requirements were met.
• Patients had good outcomes because they received effective care and treatment that met their needs.
• The practice was fully engaged with reviewing and monitoring the clinical service they offered and used this information to make changes and drive care. For example, the practice regularly reviewed data from the Clinical Commissioning Group and used this to drive improvement within the practice as well as having a comprehensive audit programme.
• Patients were supported, treated with dignity and respect and were involved as partners in their care.
• Outcomes from the GP Patient Survey were consistently in line with, or above average.
• People’s needs were met by the way in which services were organised and delivered. For example, the practice had engaged with the Volunteer Norfolk scheme which helped people get back into work.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.
• The practice encouraged continuous improvement and innovation. For example, the practice had a diverse skill mix within the practice and encouraged staff to undertake further education.
• Staff reported they were happy and proud to work in the practice.

We found the provider should:

• Monitor the compliance of staff with dispensary standard operating procedures.
• Review the safeguarding register to ensure it is updated appropriately.
• Consider the need to document discussions about prescribing and consultation reviews with non-medical prescribers.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BS BM BMedSci MRCGP
Chief Inspector of General Practice