Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wakeman`s Hill Surgery on 30 March 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. However patients responses on some areas were below average. The practice were aware of these and were working to make improvements.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment with a named GP and 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Maintain arrangements for managing emergency equipment and medicines.

• Continue efforts to address the high  overall clinical exception rate; the uptake for childhood immunisations and cervical smear uptake rate.

• Review and improve the process of identifying patients who are carers to ensure they are provided with appropriate support and advice.

• Continue to address the low performance relating to patients response from the GP national survey result published in July 2016; that showed patients found it difficult to easily access appointments and responses related to nurses.

• Review arrangements for patients at the practice who require additional support with hearing facilities.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Four patients we spoke with informed us that staff at the practice had treated them with respect and dignity. They were satisfied with the care and treatment provided. One patient told us, "The doctor is pleasant and I get the treatment I need”. Another patient said, “They are nice and I am happy to come here”. A third patient said, “The place is clean when I visit. I have no problems with getting an appointment”.

We examined the records of patients. These contained details of assessments and their past medical history. Treatment and care were documented and where necessary, consent had been obtained. Reviews of treatment took place and there was a system for following up patients who had missed important appointments. We saw certificates which indicated that the GPs and other practice staff had updated their professional knowledge and skills.

The staff records contained essential checks carried out on staff. These included criminal record checks, evidence of identity and references. There were arrangements for new staff to be provided with a period of induction. The lead GP and three administrative staff we spoke with were aware of their roles and responsibilities.

The practice had arrangements for safeguarding people from abuse. Staff were aware of action to take when responding to allegations or incidents of abuse. Safeguarding policies and procedures were in place.

There was a system of audits and checks to monitor the quality of service that patients received. Issues affecting the care of patients and the running of the practice had been discussed in Patient Participation Group (PPG) meetings. Complaints made had been responded to.