Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Marshside Surgery –Dr Wainwright (known locally as The Marshside Surgery) on 24 August 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.

• The practice used innovative and proactive methods to improve patient outcomes. For example, the practice signed up to a trial of Alivecor devices, which could be used with mobile phones to confirm whether patients have atrial fibrillation. Early diagnosis of the condition allows prompt treatment for patients.

• Feedback from patients about their care was consistently and highly positive.

• The practice worked closely with other organisations and the local community in planning how services were provided to ensure they meet patients’ needsFor example, one of the practice partners worked with hospital paediatric consultants and the community nursing teams to develop the Children’s Community Nursing Outreach Team. This service provided support for children whose condition made them vulnerable to hospital admission. This was piloted by the practice and two other surgeries locally. As a result this service was successful and now accepts GP referrals from any practice across the CCG, helping avoiding admissions of unwell children safely.

• The practice is involved with the CCG “New ways of working group”, looking at all clinical and support roles in the locality to see if there are better ways of delivering services to all patients.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients. When satisfaction scores for interactions with reception staff dipped, all staff were given further customer service and conflict resolution training.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority.
• The partners strived to deliver good outcomes for patients; where improvements were required, steps were taken to deliver these, for example in the improvement of care for diabetic patients.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

The practice hoped to introduce ‘on-line’ prescription ordering and routine appointment booking, in order to free up the telephone line for patients wanting to make an urgent appointment or speak to the GP.

The practice worked with other agencies and professionals to support continuity of care for patients. Monthly meetings with community matrons, palliative care nurses and district nurses supported staff to be up to date about patients’ needs.

The practice had up to date ‘child protection’ and ‘safeguarding vulnerable adults’ policies and procedures to support staff to identify signs of abuse and take appropriate actions.

An external infection control audit took place in August 2013 which highlighted changes required. We saw an action plan which the practice had put in place to address the issues.

Records showed the Practice Manager checked the professional registration for newly employed clinical staff and annually to show that professional registrations were up to date.

The practice had systems to identify, assess and manage risks related to the service. We looked at two significant events from 2013 and saw the changes made by the practice as a result, for example, to staff training and guidance.