Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wells City Practice on 20 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well led, effective, caring and responsive services. It was also rated as good for providing services for all of the population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• 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 practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, participation in research projects.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

• The practice facilities were extremely well designed and equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as Good overall. (Previous rating May 2015 – Good)

The key questions at this inspection 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 at Wells City Practice on 17 January 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• The practice had a good programme which ensured that childhood immunisations were taken up.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients gave mixed views on how easy the appointment system was to use and reported that they were able to access care when they needed it.
• There was a focus on continuous learning and improvement at all levels of the organisation.
• There was a mutually supportive team of staff, who worked well together with the aim of achieving the best outcomes for patients.
• Staff were given the opportunity for professional development.
• Staff signposted and worked with Health Connections Mendip to encourage patients to improve their lifestyle and manage their own health.
• The practice, with the help of the Patient Participation Group, had introduced a book club at the practice which appeared to be working well, encouraging patients to join the group, meeting and talking with others helping to reduce social isolation.

The areas where the provider should make improvements are:

• The provider should continue with developing aspects of safe with an oversight of staff’s immunisation status and ensuring the required disclosure and barring checks are in place for staff are in place before they are employed.
• The practice should continue with a programme of meeting the needs of patients with long term conditions and mental health needs.
• The practice should continue to develop a programme of clinical audit.
• The practice should continue to proactively identify carers.
• The practice should continue with monitoring there are safe systems in place for managing prescription paper and pads.
• The practice should continue with developing governance and quality assurance processes.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the report and the evidence tables for further information.