We carried out an announced comprehensive inspection at Upton Surgery on 13 February 2018 as part of our inspection programme.

At this inspection we found:

• The practice had comprehensive systems in place to manage and monitor risks to patients, staff and visitors. This included risks to the building, environment, medicines management, staffing, equipment and a range of emergencies that might affect operation.

• The practice continued to achieve 100% on the Quality Outcomes Framework and had an overall low exception reporting rate.

• The practice routinely reviewed the quality and effectiveness of the care it provided. Care and treatment was delivered according to evidence based guidelines. We saw that a wide range of clinical audits were carried out and there was a whole practice approach to improvement.

• The leadership, governance and culture were used to drive and improve the delivery of its service. All staff were involved in the development of the practice and were proud of their achievements.

• The practice reviewed the needs of their local population and had initiated positive services for patients.

• Staff treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• Services were tailored to meet the needs of individual people and were delivered in a way that ensured flexibility and choice. For example, Saturday appointments improved access for patients who were unable to attend appointments during working hours.

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. There was a strong focus on continuous learning and improvements at all levels in the practice. When incidents did happen, the practice learned from them and improved their processes.

• There was evidence that service improvement was a priority among staff and leaders. High standards were promoted by all practice staff and there was strong team working and a commitment to personal and professional development.

We saw several areas of outstanding practice:-

• The practice was forward thinking to improve the outcomes for patients in the area. There was a clear approach to seeking out and integrating services to improve patient care. It sought out opportunities to engage with the community and provide a range of accessible services to meet the needs of its population.

• The practice understood the rurality and challenges of its practice population and developed a strategy to build responsive services in line with health and social care priorities across the region. There was a clear vision and set of values. The practice had a realistic strategy and supporting business plans to achieve priorities. Strategies and plans were aligned in the wider health economy and there was a demonstrated commitment to a system wide collaboration and leadership.

• There was clear, inclusive and effective leadership at all levels. Leaders demonstrated the high levels of experience, capacity and capability needed to deliver sustainable care. There were deeply embedded systems of leadership which aimed to ensure that senior staff had considered the needs for the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Barrell and Partners on 6 September 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents had been maximised.

• Safe arrangements were in place for staff recruitment that protected patients from risks of harm. Risks to patients had been identified and assessed and well managed to minimise those risks.

• The practice was actively involved with local and national initiatives to enhance the care and treatments offered to patients. Clinical staff were proactive in identifying the current and potential needs of patients with long-term conditions.

• Patients we spoke with said they were treated with respect and they felt involved with decisions about their care and treatment. They commented about how helpful staff were towards them and described their care as good, very good or excellent. Information was available and details of support groups to help them understand about their care needs.

• Practice staff listened and when possible implemented suggestions for improvements and made changes to the way they delivered services. Information about how to make a complaint was available and easy to understand.

• There was a structured programme in place for staff annual appraisals and for planning their training needs. Staff were actively encouraged to enhance their knowledge and skills.

• A clear leadership structure was evident and staff told us they felt supported by senior staff and that there was an open culture throughout. There was a clear vision to promote high standards of care. The governance system monitored the quality of practice wide performance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice