Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Brimington Surgery on 12 April 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. Learning was applied from events to enhance the delivery of safe care to patients.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. The practice was committed to staff training and development and the practice team had the skills, knowledge and experience to deliver high quality care and effective treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice analysed and responded to feedback received from patients. The practice had recently undertaken a survey with their local care homes which demonstrated a high level of satisfaction with the care they had provided.
• 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 generally found it easy to make an appointment with a GP and urgent appointments were available the same day.

• The practice ensured they engaged with vulnerable patients to provide them with the support they needed. This included having a more flexible approach to consulting with them to ensure they could receive the care they required.

• The practice had excellent facilities and was well-equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff told us that they felt supported by management.

• The practice reviewed the skill mix of their team to meet their patients’ needs. For example, they had appointed a community practice nurse to focus on patients that were previously managed by the community matron.

• There was an active patient participation group which influenced practice developments. For example, introducing practice nurse appointments into the weekly extended hours’ surgery.
• Risks to patients were assessed and well managed, although the practice had not been formally assessed for the control and management of legionella on site.

We saw two areas of outstanding practice:

• Brimington Surgery was the first GP practice in Chesterfield to receive the Derbyshire Dignity Campaign Award in February 2016, an initiative developed by the local County Council and CCG. This reflected the passion within the practice team to provide high quality care to their patients. The practice ensured this was maintained by reviewing one of the ten action points within the award in turn at each monthly staff meeting to review what they were doing, and agree what might be done to enhance this even further. We observed a strong and visible patient-centred culture in which staff were motivated and inspired to offer personalised care that promoted people’s dignity.

• A ‘Village Friends Group’ had been established by the practice with support from their community matron, to support those patients who were bereaved. This had expanded to include patients who were socially isolated and also to include patients from other local GP practices. Activities including lunch clubs and theatre trips took place which provided an opportunity for social interaction and promoted a strong sense of local community.

The areas where the provider should make improvement are:

• The practice should ensure that health and safety related risk areas are kept under ongoing review with supporting documentation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice