Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Mannamead Surgery on 2 July 2015.

Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe well-led, effective, caring and responsive services. It was also good for providing services for the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that 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.

We found one area of outstanding practice.

The practice staff and the patient participation group are working towards making the practice dementia friendly through the use of memory boxes in the waiting rooms and dementia friendly signage. Staff and PPG members have been trained to be Dementia champions to increase awareness with all staff

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating July 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Mannamead Surgery on 6 and 7 November 2018.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• The GPs had started to hand over the management of long term conditions to the nursing staff 18 months ago. The nursing team were able to prescribe medicines associated with long term conditions. The practice had seen an increase in performance target scores in the last year alongside improved patient outcomes.
• Communication was effective at the practice and was facilitated by a routine programme of daily, weekly and monthly meetings. Communication was open, transparent and included all members of the team.
• Staff involved and treated patients with compassion, kindness, dignity and respect. Patient feedback about care and treatment was consistently positive.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. Changes to the appointment system had been made following patient feedback.
• Patients could be referred or self-refer to a pilot scheme which offered a bereavement and listening service provided by the local hospice. Patients could also access a local voluntary service providing social activities to reduce social isolation.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• GPs and the leadership team understood the challenges, had reported any concerns to external organisations and were addressing them. For example, gaps in clinical cover due to a reduced GP workforce.

We saw one outstanding area of practice:

The practice staff and the patient participation group had become the first GP practice in Plymouth to become ‘dementia friendly’. Staff had introduced dementia friendly memory boxes and picture books in the waiting rooms to trigger the memory of patients and ensured the practice had dementia friendly signage. Staff and PPG members had been trained to be Dementia champions to increase awareness with all staff.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.