Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Lea Surgery on 6 December, 2016. Overall the practice is rated as good.

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

• There was an extensive range of extended hour’s appointments available to patients seven days a week.
• 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.
• 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.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

• The practice provided patients with seven day access to the service, including a phlebotomy clinic every Saturday. Extended hours appointments were available seven days a week and the practice was open every Saturday and Sunday for routine and emergency appointments. Patient satisfaction around access to the service was significantly higher than the local and national average. For example, the percentage of respondents to the GP patient survey who were 'very satisfied' or 'fairly satisfied' with their GP practice opening hours was 92% compared to the local average of 81% and the national average of 79%. A total of 97% of patients said the last appointment they got was convenient compared to the local average of 91% and the national average of 92%.

• The practice have put a system in place to ensure continuityof care for patients discharged from secondary care services by employing a full time pharmacist at the practice. The pharmacist takes the initial lead in relation to patients being discharged from secondary care. The pharmacist phones the patient upon receiving the discharge summary to ensure that the patient understands any medication changes, has had services implemented and just as importantly ensures that the relevant pharmacy is notified of key changes so that blister packs can be amended appropriately. The pharmacist discusses any important discharge summaries with the duty doctor daily so that a plan of action can be formulated.

The areas where the provider should make improvement are:

• Review audit systems in relation to the monitoring of prescription pads in accordance with national NHS guidelines.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice