Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Oak Surgery on 10 October 2016. Overall, the practice is rated as good.

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

• There was an effective system in place for the reporting and recording of significant events. Learning was applied from events to enhance the delivery of safe care to patients.
• The practice had systems in place to safeguard children and vulnerable adults. Notes from child safeguarding meetings were recorded.

• Clinicians mostly kept themselves updated on new and revised guidance and discussed this at clinical meetings. However, we observed that recent NICE guidance relating to menopause had not been considered, although the practice took steps to ensure updates were not missed following our inspection.
• We saw some evidence of a programme of clinical audit that reviewed care and ensured actions were implemented to enhance outcomes for patients. Some audits needed to be repeated to assess impact of actions taken and whether this had improved outcomes for patients.
• Patients told us they were treated with compassion, dignity and respect. They also said they were involved in their care and decisions about their treatment. This was corroborated bythe outcomes of the latest national GP patient survey and CQC comment cards.
• The practice planned and co-ordinated patient care with the wider health and social care multi-disciplinary team to deliver effective and responsive care to keep vulnerable patients safe. Monthly meetings took place to discuss and review patients’ needs.
• The practice had an effective appraisal system in place and supported staff training and development.
• The practice team had the skills, knowledge and experience to deliver high quality care and treatment.
• There were arrangements were in place to assess and manage risk. The identification of new or emerging risks required strengthening.
• Feedback from patients we spoke with on the day, and from CQC comment cards, demonstrated that people were generally well satisfied with access to GP appointments.
• The practice had good facilities and was well-equipped to treat patients and meet their needs. The premises were accessible for patients with mobility difficulties.
• There was a clear leadership structure in place. Regular practice meetings occurred, and staff said that GPs and managers were approachable and always had time to talk with them.
• The partnership had a vision for the future and had developed clear practice values for the practice team. There was a written five-year forward plan, and the practice proactively engaged with other practices and their Clinical Commissioning Group (CCG).
• The practice had an open and transparent approach when dealing with complaints. Information about how to complain was available, and improvements were made to the quality of care as a result of any complaints received.
• The practice had a patient participation group (PPG) which had been recently formed and was meeting on a quarterly basis.

The areas where the provider should make improvement are:

• Strengthen oversight and governance systems to improve the identification and mitigation of identified risks in a timely way.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice