Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Penryn Surgery on 16 December 2015. 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.
• 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.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

The practice had developed a daily on site clinic at the local university to meet the needs of the students (which relates to 24% of the practice population) and allows students easy access to a GP without disrupting their academic timetables. They liaise closely with student support services to provide additional support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection December 2015 – Good)

The key questions 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 Penryn Surgery, visiting all three locations including the dispensaries at Penryn Surgery, Mawnan Smith Surgery and Stithians Surgery on 4 and 5 December 2018. The inspection was a routine inspection as part of our inspection schedule.

At this inspection we found:

• The practice focussed on safety. The majority of systems were clear facilitating the management of risk across all three registered locations. The practice thoroughly investigated safety events and learned from them improving processes. However, there was a lack of consistency in the way complaints and significant events were documented, which could affect the governance of these processes by the practice.
• Audit was embedded, with the practice routinely reviewing the effectiveness and appropriateness of the care it provided. Care and treatment was always delivered according to evidence-based guidelines.
• All the feedback from 12 patients at the inspection was positive about staff treating them with compassion, kindness, dignity and respect.
• People’s individual needs and preferences were central to the planning and delivery of flexible tailored services. For example, patients could attend any of the practice sites in Penryn, Mawnan Smith or Stithians for an appointment at a time to suit them.
• Patient feedback about the appointment system had been listened to. The practice had significantly increased patient access to appointments online facilitating easier access for working people.
• The practice continued to provide a daily on-site clinic at the local university to meet the needs of the students (25% of the practice population). Students were able access to a GP without disrupting their academic studies. They liaised closely with student support services to provide additional mental health support and monitoring.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Proactive succession planning based on staff development and training of future GPs, doctors and practice nurses was evident at this training practice.
• The practice was an active research practice in the Southwest, supporting and recruiting patients for research studies to improve care and treatment outcomes for patients.

We saw two areas of outstanding practice:

The practice had responded to increasing numbers of patients presenting with gender dysphoria, for whom there were limited local and regional services available. An information pack had been developed for patients, including signposting to national support agencies, referral processes to the regional gender dysphoria clinic, transition and post-surgery health screening (female to male ongoing eligibility for breast and cervical screening).

The practice held an immunisation event, with children’s entertainer, aimed at hard to reach families to increase immunisation uptake. The first event lead to seven children being vaccinated. Children were given a bag with presents for being immunised, making it a positive experience for them. The practice planned further such events and intended to hold these at the weekend.

There were areas where the provider could make improvements and should:

Review the significant event (SEA) and complaints processes to ensure there is consistent documentation of risks, actions, change and embedding for safe governance.

Develop a consistent style of response to complaints providing both empathy and timeline information for patients.

Review the arrangements for storing and monitoring of blank prescription stationery at Stithians Surgery to ensure that best practice guidance is being followed and risks minimised.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice