Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mixer and Partners on 1 April 2016. 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had 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 were able to get same day appointments and pre bookable appointments were available.
• 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 an area of outstanding practice.

• The practice provided a specialist led dermatology clinic which was operated jointly by a Dermatology Consultant and a GP with a special interest in dermatology. This incorporated minor surgery. When necessary the practice also assessed patients for cryotherapy and phototherapy treatment and patch testing. The practice employed a specialist dermatology nurse who contributed to these services. The service was available to the practices’ own patients and patients from other practices in the local area.

• The practice had also invested in a phototherapy unit which was used to treat chronic skin problems for the practice’s own patients and for other patients in the local area. This service had been running since 2011 and an audit conducted in 2013 showed very positive results. There had been a reduction of 307 patients who had not needed a referral to hospital for their treatment. The audit also measured the clinical improvement in 54 patient’s skin problem and their quality of life; in all but two patients there was improvement in both these areas. Feedback from patients was also very positive with patients describing the service as excellent. They also commented on the convenience of not having to travel to hospital for treatment and being able to access early morning appointments before they started work.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Ensure staff have access to procedures for the management of controlled drugs.

• Ensure all staff are up to date with mandatory training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice