Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Summerfield group Practice on 7 November 2016. The overall rating for the practice was good; however, the practice was rated as requires improvement for providing effective services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Summerfield group Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 6 December 2017 to confirm that the practice had carried out their plan to make improvements in relation to the effectiveness of quality improvement activities; the management, monitoring and improvement of outcomes for people; as well as improving patient satisfaction in areas such as access we identified in our previous inspection on 7 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice continues to be rated as good.

Our key findings were as follows:

• Since our previous inspection, the practice improved their use of quality assurance activities. For example, clinical audits demonstrated quality improvements.

• Data from the 2016/17 Quality and Outcomes Framework showed patient outcomes were comparable to local and national averages in most areas. However, outcomes for diabetes care were lower than local averages. Staff were aware of areas which required further improvements and unverified data provided by the practice demonstrated that they were working towards 2017/18 targets.

• Staff were aware of the complexity of the patient population group and worked with other health care professionals to improve engagement and increase the uptake of national screening programmes.

• Since our previous inspection, the practice implemented measures to ensure all equipment calibration checks were carried out and contracts for annual checks were in place.

• Data provided by the practice showed that the carers register had eight patients (0.1% of the practice list). Staff we spoke with during our inspection, explained low identification of carers was reflective of the young patient population. Since our previous inspection, the practice had reviewed their carers list and a designated member of staff was in charge of maintaining and updating carers’ records. There were posters in the reception area and the new patient registration form supported the identification of carers.

• During our previous inspection, staff explained the practice had increased their phone lines in order to improve access and patient satisfaction.

• Data from the national GP patient survey published July 2017 showed that 54% found it easy getting through to the practice by phone, compared to local averages of 60% and national average of 71%; demonstrating a 2% improvement since our previous inspection. The practice also carried out their own survey which identified 76% of patients found it easy to get through by phone and 23% found it hard.

However, there were also areas of practice where the provider should make improvements. For example:

• Establish a system for sharing national guideline updates and learning from quality assurance activities.

• Continue working with community health teams and establishing effective processes to improve the uptake of national screening programmes and the uptake of childhood immunisations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Summerfield Group Practice on 7 November 2016. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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.
• The practice spoke about challenges faced to recruit permanent GPs to the practice but systems were in place to ensure sufficient cover.
• 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.
• Patient feedback showed access to appointments was similar to other practices locally however patients at this practice found it more difficult to get through on the phone
• Urgent appointments were 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 and staff felt supported by management. The practice proactively sought feedback from patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw an area of outstanding practice:

• The practice estimated approximately 90% of patients had English as a second language and 99 different languages were spoken among patients on their practice list. There was a high need for translators. In response to this the practice had regular block bookings each week with translators for five different languages , they could then offer patients of these languages appointments in which a translator was available. Staff told us that having translators on-site meant they were more efficient and were able to keep appointments to time.

The areas where the provider should make improvement are:

• Ensure equipment calibration checks include all relevant clinical equipment.
• Review how the use of clinical audits may better support service improvement.
• Review processes for managing diabetes at the practice to see how this might be improved.
• Ensure patients with a learning disability receive the opportunity for an annual health review.
• Identify and implement actions to improve uptake of national screening programms for bowel and breast cancer.
• Review and implement ways in which the identification of carers might be improved so that they may receive support.
• Review how the practice might further improve telephone access.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice