We carried out an announced comprehensive inspection at The Guildhall and Barrow Surgery on 19 December 2018 as part of our inspection programme. The practice was previously inspected in December 2014 and rated as good.

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.
• Patients were supported, treated with dignity and respect and were involved in their care.
• People’s needs were met by the way in which services were organised and delivered.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.
• Staff reported they were happy to work in the practice and proud of the changes that had been made.

Whilst we found no breaches of regulations, the provider should:

• Complete prescribing audits for the non-clinical prescribers.

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

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of The Guildhall and Barrow surgery on 12 December 2014 under our new approach for primary medical services.

We found that The Guildhall & Barrow surgery provided a good service to patients in all of the five key areas we looked at. The practice provided a good service to patients across all age ranges and to patients with varied needs due to their health or social circumstances.

Our key findings were as follows:

There were systems in place to provide a safe, effective, caring, responsive and well led service. Patients and staff were kept safe because processes and procedures were being followed. Safety incidents were thoroughly investigated, analysed and learning opportunities had been identified. Robust infection control procedures were in place.

The practice was a caring practice with high quality committed GPs who provided a high level of personal care to their patients through the use of a “personal list” system. The staff were very committed to acting in the best interests of the patients. For example older patients were offered double and triple appointments in order that they could discuss multiple and complex issues during one visit to the surgery

Patients were satisfied with the service and felt they were treated with dignity, care and respect and involved in decisions about their care and treatment.

The surgery had developed a philosophy to ensure staff were well trained. There was strong visible leadership in place with an ethos of learning and improvement embedded into their procedures.

Monitoring and assessment of the services provided was achieved through a range of clinical and non-clinical audits. These were clear, concise and identified areas for improvement that had been followed up by timely action.

The practice operated a personal list system whereby each patient had a named GP. Families often shared the same named GP and this allowed GPs to identify the needs of family carers more quickly. Patients confirmed to us that they valued the personal list arrangement highly, as they felt that it afforded them personalised care from a GP that they knew and trusted.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During our inspection we spoke with six people who used the service and two people’s relatives. All of the people we spoke with told us that they thought the surgery provided an excellent service.

One person told us, “It’s very good. I have no problem getting an appointment and you always get to see your own doctor unless it’s an emergency.” Another person told us, “I’m very pleased with the service and I can’t think of a thing they could improve.”

We found care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. There were arrangements in place to deal with foreseeable emergencies.

Medicines, including controlled medicines, were recorded, handled, stored and disposed of safely.

As part of our inspection we spoke with seven members of staff including clinical staff. We found staff received the appropriate and essential training required to maintain their skills.

Staff we spoke with all said they felt well supported. One member of staff told us, “Everyone is responsive and supportive here. I can’t think of anything I would change.” Another member of staff told us, “It’s well structured, well organised and well run.”

We found that people who used the service and staff were asked for their views about the care and treatment being delivered. People’s feedback was listened to and changes were made where and when appropriate.