Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Bartlett and Partners on the 8 September 2016. We visited the main surgery in West Ayton and the branch surgeries at Snainton and Seamer during the inspection. 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were able to get same day appointments and pre bookable appointments were available.
• 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 an area of outstanding practice:

• The PPG had supported the practice to run two successful ‘Health Information Days’ in one in 2015 which 70 people attended and one in July 2016 which 200 people attended. There were various local statutory and voluntary organisations represented on the day for example; Dementia Friends, the Carers Resource Centre, a local housing provider and the local library. Practice staff also provided opportunistic health checks such as blood pressure and diabetes for people attending the event. A PPG member was available to talk to patients about joining the PPG. The PPG was working with the practice on their next event, ‘Keep Well for Winter’ which was going to be held in November 2016.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Develop a documented cleaning programme for carpets and privacy curtains in all four surgeries.

• Implement processes so that all Standing Operating Procedures (SOPs) include all aspects of the dispensing process and new SOPs have been read and signed by staff.

• Put systems in place to monitor blank prescriptions in line with national guidance.

• Monitor that all staff are up to date with mandatory training.

• Monitor minor surgery outcomes including the process for obtaining consent.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Patients told us they felt their privacy and dignity was protected when they visited the practice. Comments included; “The doctors are all good and they listen to your concerns" and “They seem to have a flexible approach to the care of their patients here which is good”. Another patient told us “The doctor always takes their time and treats me with respect. They talk to me using layman terms so I can understand what the issues are.” People told us they felt safe using the surgery.

There was also a patient participation group (PPG). A PPG is made up of volunteer patients and practice staff who meet regularly to discuss the services on offer and how improvements can be made for the benefits of the local community. They told us the group had given patients a strong voice and were currently working with the local library, which was now a community resource.

A GP we spoke with said that they gave the time someone needed in an appointment to ensure they understood about their treatment. Where it was necessary patients told us that timely referrals had been made to other services for assessment and treatment. We saw the results of the national patient survey and these indicated that 96% of patients felt they got enough time at their appointments and they involved them in their care.

Medicines were prescribed and dispensed to patients appropriately. There were two surgeries that had dispensaries. Staff told us that patients who were eligible had the choice of having their medicines dispensed at the surgery or their local pharmacy.

We saw systems in place to monitor the quality of the services provided at the surgery. This meant that patients could be confident they were receiving a good service.

We reviewed the information available to us about Ayton and Snainton Medical Practice on 11 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.