Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stonecot Surgery on 10 January 2017. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning from internal and external incidents were maximised.
• Risks to patients were assessed and well managed; however, they had not ensured that all staff had received fire safety training and had not completed any full evacuation fire drills.
• 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 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.
• The practice had an established Patient Participation Group, which it consulted with regularly in order to gather patients’ views of proposed changes within the practice.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• The practice had a programme of continuous clinical audit, which was informed by both incidents within the practice and external factors. We saw evidence that the outcomes of audits was used to drive improvement within the practice.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

The practice was committed to securing the future of general practice. This was demonstrated by their commitment to the training of doctors and nurses; the practice provided placement opportunities to medical students, GP registrars, nursing students, physician’s associates and pharmacists undertaking the non-medical prescriber course.

The management team were dedicated to ensuring that all patients at the practice received the care and treatment they required, and this ethos was embedded in the way that tasks were carried-out at the practice. For example, the partners had a low tolerance for excepting patients from the Quality Outcomes Framework (QOF) and the practice was committed to engaging with patients to ensure that their existing health conditions were well managed and that they participated in preventative screening. The success of this approach was demonstrated by the practice’s high QOF achievement, low rate of exception reporting, and their high uptake of bowel, breast and cervical cancer screening. The practice’s rate of outpatient attendance and unplanned hospital admission were significantly below the expected rate for their patient population.

The areas where the provider should make improvement are:

• Ensure that all staff have received fire safety training and carry-out full evacuation fire drills.
• Put processes in place to ensure that all regular locum staff are up to date with mandatory training.
• Consider ways to allow patients without access to a computer to participate in the PPG.
• Put in place a failsafe system to ensure that results are received for all samples submitted for the cervical screening programme.
• Advertise the availability of translation services to patients in the waiting area.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

During our inspection we spoke with the practice manager, two General Practitioners (GP), the practice nurse, the medical secretary, an administrative assistant, and two receptionists.

We also spoke with seven people who regularly used the surgery. They told us that overall they felt satisfied with the service they received from the Stonecot practise. One patient said “it’s a marvellous surgery and I would recommend it”. Another patient told us “reception staff are excellent; they always seem to know what I need”.

We saw the results of the surgery’s most recent patient survey that had been conducted on behalf of NHS England which indicated that ninety-five percent of patients who had participated had confidence and trust in the GP they saw. Furthermore, ninety-one percent said they would recommend Stonecot surgery to someone who had just moved to the local area.

We found patients received safe and appropriate care and treatment from suitably trained and experienced clinical and non-clinical staff. We saw all staff respected patients privacy and dignity, and involved them in discussions about their care and treatment. We saw the surgery’s physical environment was kept safe and clean. We also found the surgery had developed effective systems to continually monitor the quality of the service they provided. Finally, it was evident that the surgery took patients concerns seriously and always tried to resolve them to the patients satisfaction.